Senate Committee Kills Public Option Proposals

[Garibaldi]

NYTimes

WASHINGTON — After an intense debate that captured the essence of the national struggle over health care, a pivotal Senate committee on Tuesday rejected two Democratic proposals to create a government insurance plan to compete with private insurers.

The votes, in the Senate Finance Committee, underscored divisions among Democrats and were a setback for President Obama, who has endorsed the public plan as a way to “keep insurance companies honest.”

The first proposal, by Senator John D. Rockefeller IV of West Virginia, was rejected 15 to 8, as five Democrats joined all Republicans on the panel in voting no. The second proposal, by Senator Charles E. Schumer of New York, was defeated 13 to 10, with three Democrats voting no.

The votes vindicated the middle-of-the-road approach taken by the committee chairman, Senator Max Baucus, Democrat of Montana. Mr. Baucus voted against both proposals, which were offered as amendments to his bill to expand coverage and rein in health costs.

“There’s a lot to like about a public option,” Mr. Baucus said, but he asserted that the idea could not get the 60 votes needed to overcome a Republican filibuster on the Senate floor.

Proponents of a public plan said it was needed to compete with private insurers, and they said consumers would benefit from the competition, getting lower prices and better benefits.

Republicans on the committee unanimously opposed the public option, saying it was, in the words of Senator Orrin G. Hatch of Utah, “a Trojan horse for a single-payer system” in which the government would eventually control most health care.

Mr. Obama has said he wants a public plan, but he has not always insisted on it, and the administration has sent mixed signals about how important it is. In the debate on Tuesday, few senators mentioned the president’s preferences, although several noted that many House Democrats, including Speaker Nancy Pelosi, supported the public option.

House Democratic leaders met for several hours on Tuesday to continue the dicey work of melding bills from three committees into a consensus package that could win a House majority.

Mr. Schumer said the public option would hold down costs because it would not have to generate profits, answer to shareholders or incur marketing expenses. His proposal would have required the public plan to negotiate rates with doctors and hospitals, rather than setting prices based on Medicare reimbursement rates. Under Mr. Rockefeller’s plan, the payment of doctors and hospitals would have been based on Medicare rates for the first two years.

Mr. Rockefeller said the Congressional Budget Office had estimated that a government insurance plan could slice $50 billion from the cost of Mr. Baucus’s bill, originally put at $774 billion over 10 years. The budget office predicted that eight million people would initially enroll in the public plan — about one-third of those who would seek coverage through new markets, or insurance exchanges.

“The public plan will be optional,” Mr. Rockefeller insisted. “It will be voluntary. It will be affordable to people who are now helpless before their insurance companies.”

But Senator Charles E. Grassley of Iowa, the senior Republican on the committee, said a government insurance plan would have inherent advantages over private insurers. “Government is not a fair competitor,” Mr. Grassley said. “It’s a predator.” He predicted that “a government plan will ultimately force private insurers out of business,” reducing choices for consumers.

Senator John Ensign, Republican of Nevada, said he feared that a government plan would prove so popular it could never be uprooted. “Does anybody believe Congress would let this public plan go away once it has a constituency?” Mr. Ensign asked. “No way. Once it’s started, you will never get rid of it. Congress will subsidize it more and more, allow it to grow and grow.”

Besides Mr. Baucus, two Democrats, Senators Kent Conrad of North Dakota and Blanche Lincoln of Arkansas, voted against both public option proposals. Two other Democrats, Senators Thomas R. Carper of Delaware and Bill Nelson of Florida, voted against the first amendment, but supported the second.

Mr. Carper said he liked Mr. Schumer’s proposal because it “would establish a level playing field” for competition between private insurers and the government plan.

The votes on Tuesday set the stage for a compromise under which the public plan could be offered in states where people could not find affordable private coverage, Mr. Carper said. He and Senator Olympia J. Snowe, Republican of Maine, have proposed such a compromise.

Democrats hope Ms. Snowe will eventually break with her party and support the legislation.

In the House, the Democratic leader, Representative Steny H. Hoyer of Maryland, echoed Mr. Schumer’s argument that the Finance Committee was the least friendly of the forums that would consider a public option.

“The Senate floor may be better, and the conference even better,” Mr. Hoyer said, looking ahead to negotiations where differences between the two chambers might be resolved.

Senator Lincoln, who faces an increasingly competitive race for re-election next year, said she supported efforts to cover the uninsured and to protect consumers by imposing strict new federal rules on insurance companies. But she said Congress could achieve those goals “without creating a purely public new government program, which most Arkansans do not support.”

Mr. Baucus’s bill does not include a public plan, but would set up nonprofit insurance cooperatives as an alternative to private insurers. The Congressional Budget Office has suggested that the cooperatives would have little effect on federal costs.

Mr. Rockefeller and Mr. Schumer were undaunted. “We will keep fighting so the bill that lands on the president’s desk has a good, strong, robust public option,” Mr. Schumer said.

It's not "dead" dead, but it's nice to be reminded that the entire progressive wing of the Democratic Party is powerless before a corporate stooge like Baucus.

[Knife]

Seems that particular Commitee has a shit load of Blue Dogs on it, go figure. That said, four out of five bills have the public option on it, only this one doesn't. It's not dead.

[Scottish Ninja]

Senator John Ensign, Republican of Nevada, said he feared that a government plan would prove so popular it could never be uprooted. “Does anybody believe Congress would let this public plan go away once it has a constituency?” Mr. Ensign asked. “No way. Once it’s started, you will never get rid of it. Congress will subsidize it more and more, allow it to grow and grow.”

Ahahahahaha! "People would like it, so it's bad!"

That's an especially funny statement when you compare it to:

But Senator Charles E. Grassley of Iowa, the senior Republican on the committee, said a government insurance plan would have inherent advantages over private insurers. “Government is not a fair competitor,” Mr. Grassley said. “It’s a predator.” He predicted that “a government plan will ultimately force private insurers out of business,” reducing choices for consumers.

So... it would be really popular, but... the people who would lose choices they won't want?

That neatly illustrates how the Republicans are only interested in protecting corporate profits, once again.

[Ryan Thunder]

Quite. The cognitive dissonance was so bad it left me speechless when I was listening to them try to explain it on CNN this morning.

[Darth Raptor]

Nonsense. Representative democracy is alive and well in America. Just look at how loyal the Senators from Blue Cross and Blue Shield are to their constituents. Makes me wish I could afford a Senator or two.

[Themightytom]

Just because the Comittee dropped it doesn't mean its dead. it will proabaly be reintroduced on the senate floor. The Committee represents conservative liberals and conservatives, so they are somewhat like minded and represent a similiar enough viewpoint. the senate on the other hand leans much ffarther to the left as a whole.

[Bluewolf]

Even if it is not dead, I can understand why people will find this troubling. Hopefully you should be right though as the public option feels like it is being juggled about between dropping it and having it.

[Darth Wong]

But Senator Charles E. Grassley of Iowa, the senior Republican on the committee, said a government insurance plan would have inherent advantages over private insurers. “Government is not a fair competitor,” Mr. Grassley said. “It’s a predator.” He predicted that “a government plan will ultimately force private insurers out of business,” reducing choices for consumers.

We must eliminate this choice so that consumers will have more choices! Ignorance is strength! Freedom is slavery!

What this douchebag really means is that they want to restrict consumers' choices so that they will only be able to choose options which enrich Wall Street. Given direct competition and free choice between his insurance industry friends and a non-profit public insurer, the people would not choose the way he wants them to choose, and that's unacceptable.

[Rogue 9]

Well, the Republican logic goes as such: When government enters a business, it inherently competes unfairly because the government does not need to make a profit and cannot go out of business, and can therefore do things that no private business can afford to do to get and keep customers, mainly by undercutting private sector prices due to the aforementioned lack of need for profit and making up the difference either out of the tax base or through good old deficit spending.

What this leaves out, of course, is how this is an inherently bad thing in a field such as healthcare. If the government were, say, entering heavy manufacturing, the service sector outside of the essential services it provides now, agriculture, or something else where the choice isn't between profit and peoples' lives, I'd see a major problem, but healthcare should really be viewed in the same light as fire and police services; the private sector does not compete in those areas, nor should it.

[Darth Wong]

There's an old litmus test for whether something should be provided by the public sector or the private sector:

1) Does it provide a public good, ie- does it benefit everyone?
2) Is it something that individuals should not be excluded from?

Generally speaking, consumer goods fail this test, which is why the government should not make them. Big-screen TVs do not provide a public benefit, and there is nothing wrong with excluding people from having big-screen TVs. However, health-care meets this test. It is a public good for various reasons, and it is something that people should not be excluded from using, regardless of whether they can afford to pay.

[Knife]

Even if it is not dead, I can understand why people will find this troubling. Hopefully you should be right though as the public option feels like it is being juggled about between dropping it and having it.

That's just the perception in the media. The House Bill that was passed a while ago has the public option in it, the other Senate Bill from the Health and whatever committee, has the public option. It is just this one committee's Bill that has received all the press and the on again, off again juggling of the public option.

[Ryan Thunder]

There's an old litmus test for whether something should be provided by the public sector or the private sector:

1) Does it provide a public good, ie- does it benefit everyone?
2) Is it something that individuals should not be excluded from?

Generally speaking, consumer goods fail this test, which is why the government should not make them. Big-screen TVs do not provide a public benefit, and there is nothing wrong with excluding people from having big-screen TVs. However, health-care meets this test. It is a public good for various reasons, and it is something that people should not be excluded from using, regardless of whether they can afford to pay.

Minor tangent; would you agree that food production falls under that category?

[Rogue 9]

There's an old litmus test for whether something should be provided by the public sector or the private sector:

1) Does it provide a public good, ie- does it benefit everyone?
2) Is it something that individuals should not be excluded from?

Generally speaking, consumer goods fail this test, which is why the government should not make them. Big-screen TVs do not provide a public benefit, and there is nothing wrong with excluding people from having big-screen TVs. However, health-care meets this test. It is a public good for various reasons, and it is something that people should not be excluded from using, regardless of whether they can afford to pay.

Minor tangent; would you agree that food production falls under that category?

While I'm not Mike, I'll give my own answer. Partially, the government already has in the United States and many other countries; farm subsidies perform that role even though it isn't the government's name on the deed. As for whether or not it should, I say it depends on the type of food and the situation; if there's a shortage of staples such that citizens are unable to afford to keep themselves fed even with welfare, then yes. We are, however, a long way from that point. What the government should not take over even if we hit that point are luxury foods. People need to eat; they don't need to eat steak and lobster.

[Darth Wong]

Minor tangent; would you agree that food production falls under that category?

To the extent that it is required for survival, yes. That's one of the reasons agriculture is heavily regulated and subject to various socialist protections, and why food rationing would be brought under government control in the event of an emergency. Unfortunately, government protection of agriculture tends to go far beyond that.

[The Defenestrator]

Minor tangent; would you agree that food production falls under that category?

To the extent that it is required for survival, yes. That's one of the reasons agriculture is heavily regulated and subject to various socialist protections, and why food rationing would be brought under government control in the event of an emergency. Unfortunately, government protection of agriculture tends to go far beyond that.

That's probably also the reason for the Food Stamp Program.

[Qwerty 42]

Food does have a handful of protective measures: where I live, the state is allowed to designate that a certain parcel of land may only be used for farming regardless of whose hands its in, and most thing you'd buy at a grocery store that would be categorized as "essential" (bread, raw meats, fruits, vegetables, etc.) are not subject to a sales tax.

[Mr Bean]

That's probably also the reason for the Food Stamp Program.

Not quite, Food Stamps were a program that grew out of legitimate fears that those with children who were poor were often spending their unemployment checks or other poverty related program money on booze, cigarettes and drugs. By giving a portion of the money in Food-stamps which generally speaking only Grocery stores accept it ensure that poor parents always at least buy Food with part of their poverty check.

It's not needed for most people, but damn if I can count the number of times while I was living in the south that various people stopped either my mother or myself when I was older and offered to pay our grocery bill if we would pay them the difference in cash, always with some hard luck story about need extra to pay rent or medical bills. Never mind that they might be stinking of booze at the moment or glazed eyed with needle marks visible on their arms.

[Gil Hamilton]

On the other hand, there are alot of people that Food Stamps legitimately have helped. My family was one of them, back when my father was laid off during the 80s downturn and had trouble finding work for several years. The process for getting on welfare, food stamps, et cetera is long and humilitating for honest decent people, but it does keep them from going under.

[Uraniun235]

“There’s a lot to like about a public option,” Mr. Baucus said, but he asserted that the idea could not get the 60 votes needed to overcome a Republican filibuster on the Senate floor.

I say fuck 'em. Let them filibuster. Hit them with a public option and hold fast on it, and let them filibuster it for as long as they like. It's better than caving every time someone cries about not having sixty votes on the Senate.

[Scottish Ninja]

“There’s a lot to like about a public option,” Mr. Baucus said, but he asserted that the idea could not get the 60 votes needed to overcome a Republican filibuster on the Senate floor.

I say fuck 'em. Let them filibuster. Hit them with a public option and hold fast on it, and let them filibuster it for as long as they like. It's better than caving every time someone cries about not having sixty votes on the Senate.

This is what I've been saying for a long time, mainly because since I don't think anyone's actually had to filibuster anything for a while, they just had to threaten to do it and then a cloture vote would immediately be called. Let's see the Republicans actually get up there and shut down the Senate for a while.

They don't have the guts to do it.

[Garibaldi]

I say fuck 'em. Let them filibuster. Hit them with a public option and hold fast on it, and let them filibuster it for as long as they like. It's better than caving every time someone cries about not having sixty votes on the Senate.

Baucus doesn't care one way or another about a filibuster; that excuse is just a thin smokescreen. This is a guy who took in something like 1.5 million dollars from the healthcare industry last year alone. He's completely bought and paid for; the filibuster excuse is just a poor attempt to hide the strings tying him to his corporate masters.

[Glocksman]

On the other hand, there are alot of people that Food Stamps legitimately have helped. My family was one of them, back when my father was laid off during the 80s downturn and had trouble finding work for several years. The process for getting on welfare, food stamps, et cetera is long and humilitating for honest decent people, but it does keep them from going under.

After my parents divorced in the early 1970's, my Dad moved to Canada for a while in order to avoid paying child support*.

While he was in Canada, my mother was literally working 80 hours a week as a nurse's aide in order to feed, house, and clothe my two sisters and myself.

Despite her double shift augmented income, we qualified for food stamps until my Dad moved back and started paying child support.

Did she like being on the 'dole'?
Hell no, she hated it because it made her feel low.

If it had only been about her, she would have lived on baloney and mustard rather than take government aid.
But since she had three kids to take care of, she took the dole.
Not only that, but in what I considered surprising until I learned about the labor movement, while we were kids her health insurance sucked despite working at a hospital.
Back in 7th grade I ran a sewing machine needle through the tip of my finger during Home Ec class.
She couldn't afford the tetanus shot at the time, so the head nurse of her unit told Mom to bring me in during their break and she'd give me the shot 'off the books'.

Not only that, there was a suspicious lump on my chin (turned out to be a benign bone growth) that both my Mom and the ER doc she worked with at the time were concerned about.
He not only treated me free of charge, he made it possible for the X-rays and associated lab costs to 'disappear'.

Looking back on it, my experiences are what has always driven my support for so called 'socialist' health care schemes even during my full throated wingnut phase when I made Shep look like some kind of DFH by way of comparison.


* One tale has it that he moved back after the Canadian courts made it clear that they'd enforce legitimate US court issued child support requirements.
The other tale has it that he became regretful and came back on his own.

Personally I found that hard to believe, but he has surprised me in the past and I could very well have been wrong.
One of my mother's final requests as she literally lay dying of the pancreatic cancer that killed her a week later was to see and talk to my father.

I thought it surprising at the time that he was willing to do without all of us making threats of never seeing any of us ever again if he refused, despite his second wife's dislike of my Mother.

I misjudged him, and I was pleasantly surprised by his willingness to just spend time with her and reminisce about when they were teenagers during the late 50's/early 60's.

[KroLazuxy_87]

Anyone else noticed how quiet the Heath Insurance Industry has been? IMHO they're staying out of the media light while shilling out big bucks trying to buy votes against a public option. If a bill gets passed without a public option but still requires coverage of everyone, they get thirty million new customers.