Sparse news coverage of US health care scandal

[Darth Wong]

The scandal in this case is a health insurance practice called "rescission", and the amazing way the US health insurance executives openly refuse to change their policies on it:

http://www.cnn.com/2009/POLITICS/06/19/ ... index.html

Commentary: Health care outrage goes uncovered
By Paul Begala
CNN Contributor

Editor's note: Paul Begala, a Democratic strategist and CNN political contributor, was a political consultant for Bill Clinton's presidential campaign in 1992 and was counselor to Clinton in the White House. He is an affiliated professor at Georgetown University's Public Policy Institute and an adviser to the Service Employees International Union, which supports President Obama's health care plan.

(CNN) -- You probably have never heard of Robin Beaton, and that's what's wrong with the debate over health care reform.

Beaton, a retired nurse from Waxahachie, Texas, had health insurance -- or so she thought. She paid her premiums faithfully every month, but when she was diagnosed with aggressive breast cancer, her health insurance company, Blue Cross, dumped her.

The insurance company said the fact that she had seen a dermatologist for acne, who mistakenly entered a notation on her chart that suggested her simple acne was a precancerous condition, allowed Blue Cross to leave her in the lurch.

Beaton testified before a House subcommittee this week. So did other Americans who thought they had insurance but got the shaft. As Karen Tumulty of Time magazine (who has been the journalistic conscience of health care coverage) wrote, other witnesses included:

"Peggy Raddatz, whose brother Otto Raddatz lost his insurance coverage right before he was scheduled to receive an expensive stem-cell transplant to treat his lymphoma. Why? Because Fortis Insurance Company discovered his doctor had found gall stones and an aneurysm on a CT scan -- conditions that had nothing to do with his cancer, that never bothered him and that he wasn't even aware of. And Jennifer Wittney Horton of Los Angeles, California, whose coverage was canceled because she had been taking a drug for irregular menstruation. Now, she can't get coverage anywhere else. 'Since my rescission, I have had to take jobs that I do not want, and put my career goals on hold to ensure that I can find health insurance,' she told the subcommittee."

The subcommittee's chairman, Democrat Bart Stupak of Michigan, called the hearing to highlight the obnoxious and unethical practice called rescission. His researchers produced performance reviews of insurance company bureaucrats who were praised and rewarded for kicking people off their coverage.

Then Stupak asked three health insurance executives the big question: Will your company pledge to end the practice of rescission except in cases of intentional fraud?

All three health insurance executives said no.

It was as dramatic as congressional testimony gets. Yet it got no airtime on the networks, nor, as far as I can tell, on cable news, although CNN.com did run a story. Time's Tumulty was all over it, as was Lisa Girion of The Lost Angeles Times. But the story did not make The New York Times.

Nor The Washington Post, which found space on the front page the morning after the hearing for a story on the cancellation of Fourth of July fireworks in Shippensburg, Pennsylvania, but not a story on the cancellation of health insurance for deathly ill Americans who've paid their premiums.

Stupak, and the Energy and Commerce Committee chairman, Henry Waxman, D-California, did their job. Why didn't the media do its? Why were the outrages uncovered by Stupak and Waxman un-covered by most of the media?

Maybe because the Obama White House drew the spotlight away from health care. They'd diverted the media to cover Obama's proposed reforms of the financial regulatory system.

On the last day of the 1992 Clinton-Gore campaign, we had the media A-Team traveling with us. So I made it my business to sit next to David Gergen, then with U.S. News & World Report but a former top aide to Presidents Nixon, Ford and Reagan (at that point -- little did I know he would soon be working for President Clinton). I had never seen a communications shop as effective as Reagan's, and I wasn't going to miss an opportunity to learn from a master. Gergen told me an anecdote I still remember vividly.

In the opening months of the Reagan presidency, it was the economy, stupid. America was mired in a recession, and President Reagan wanted to focus the nation's attention on his economic plan. But Secretary of State Al Haig had other ideas. The State Department had nothing to do with the economy, and Haig had ambitious plans. So, Gergen told me, Haig got a bunch of good press, advocating for intercepting Cuban gun runners (if memory serves).

You would think a staunch anti-Communist such as Reagan would have been happy. But, no. Reagan's chief of staff, James Baker, upbraided Haig for diverting media attention away from the primary goal: passing the president's economic plan.

I never forgot Gergen's story -- especially when the Clinton White House wandered off message as it tried to pursue fundamental reform of the health care system.

The economic plan eclipsed health care for much of Clinton's first year. As did NAFTA. And the crime bill, which included the Brady Bill and other gun control measures. And don't forget gays in the military. And a foreign policy crisis in Somalia -- and another in Haiti. And another in Russia.

Clinton gave his health care address to the Congress on September 23, 1993. October was supposed to be "Health Care Month" in the White House, but so many other issues got in the way that he had just one public event focused on health care in the entire month -- just one.

I understand that Obama's White House team has to juggle a lot of issues; I've been there. And I'm sure the Obama financial reforms have merit. But if the president wants to pass his ambitious health care reform, he's going to have to put other, worthy, ideas on the back burner and shine the media spotlight on the plight of people like Robin Beaton.

Personally, I think there's a more self-serving reason this gets so little coverage: the media already has its "narrative" (to steal Jon Stewart's preferred nomenclature) on health care, so it doesn't care to publicize anything new. After all, to do so now would be to admit that their previous narrative was wrong, and they can't do that, can they? It's like Iraq; how long did it take them to admit that the whole reason for entering was a lie? Years, and even then, only because they had managed to convince themselves that they were lied to so they bore no responsibility. This time, they don't have that (incredibly flimsy) excuse. And in both cases, there's some nationalistic jingoism in there too.

The narrative is simple: "there are lots of uninsured people in the US, but for everyone else, the US has the greatest health care system in the world, certainly much better than those disgusting socialized systems they have in every other first-world country. So the only thing we need to change is to make sure everyone can get this wonderful thing called "American private free-market health insurance", and we'll be fine."

Testimony like this throws a bomb into that whole narrative, and could threaten to blow it apart if somebody sets it off. So let's ... tip toe ... around it and not tell anyone it's there!

[Guardsman Bass]

The narrative is simple: "there are lots of uninsured people in the US, but for everyone else, the US has the greatest health care system in the world, certainly much better than those disgusting socialized systems they have in every other first-world country. So the only thing we need to change is to make sure everyone can get this wonderful thing called "American private free-market health insurance", and we'll be fine."

What bothers me is that I don't see a major organized effort among the left-leaning health care advocacy groups, who by all rights should be the ones going directly on the attack against that narrative (armed with things like the bankruptcy study and this), trying to challenge this narrative with tv ads and the like. Instead, it's become all about the uninsured, and even most of the arguments being made on the public plan are that it will promote "competition" rather than providing health care at a lower cost.

I can understand the Congressional Democrats being slow on this - they're afraid of election challenges, of the Blue Dogs defecting because they didn't get 70-75 Yes Votes on a health care reform in the Senate, and just generally about getting into a massive public fight with the insurance companies complete with negative ads and so forth. I wish they would relish a fight a bit more.

[Darth Wong]

Part of the reason left-leaning groups don't challenge the narrative is that it's such a hard-sell. Americans are neurotically predisposed to believe without question in certain dogmas such as the benevolence of the free market and the superiority of American uniqueness, and any challenge to this narrative would face both of those beliefs at once.

It seems to me that a lot of health-care activists know perfectly well what a load of bullshit this all is, but they're taking the "fight the battles you can win" approach.

An incremental approach might still work, if they can get a public insurer created, and let that insurer sell its product with aggressive attack ads. Once you package public insurance as a product, you can tout its benefits compared to the competition.

For example:
STATE INSURANCE
- Other insurers have lifetime benefit caps. If your treatment becomes too expensive, they cut you off! Imagine what that could do to your family.
- Other insurers have co-pays. If your treatment costs $100,000, you will be charged as much as $20,000 or $30,000. Can you afford that?
- Other insurers have "rescission", which is the process of retroactively revoking your insurance because they found an irregularity in your application, even if it was a clerical error five years ago. Can you afford the risk that they will do this to you when you need them?

If you actually took the terms and conditions of Ontario's public health insurance policy and marketed it as a competing product relative to typical American health insurance products, it would look pretty damned good, even with the "up to half of patients may have to wait more than 18 weeks for certain specialist procedures such as hip replacement" disclaimer, especially when you point out that it's actually cheaper.

Mind you, this "public insurer competing with private insurer" solution in the US is still a horribly imperfect solution. The problem with public insurance competing with private insurance is that private insurers will continue to offer these shitty policies with all of their fine print and tricks, so healthy people will buy them anyway because they're cheap and they don't think they'll ever get sick. Unfortunately, these are the people you need contributing to an insurance pool in order to lower costs for everyone else. Insurance is all about risk pooling after all, and if the low-risk people take themselves out of the pool, the costs will skyrocket for everyone who's still in it.

[PeZook]

You know, if real life was like a movie, people would be burning down those insurance companies en masse right now.

[The Duchess of Zeon]

My biggest fear is that private insurance will be made mandatory without a public option, which would be the worst of both worlds. How the hell am I supposed to afford insurance right now, insurance that won't cover any of my current medical problems, and essentially does nothing for me and can be dropped on a whim? If the Republicans succeed in preventing the addition of a public option while forcing people to buy private insurance, that tears it; the US is an unlivable country.

[Uraniun235]

You know, if real life was like a movie, people would be burning down those insurance companies en masse right now.

Clearly, we live in such a civilized country that people do not engage in such brutal displays of vigilante violence.

[PeZook]

You know, if real life was like a movie, people would be burning down those insurance companies en masse right now.

Clearly, we live in such a civilized country that people do not engage in such brutal displays of vigilante violence.

Well, yes. But movies (well, those with a happy ending) generally have the big, evil corporation get what's coming to it. It's clearly what a lot of people would like to do, and maybe would, if pushed far enough.

I'm astounded at the amount of abuse the American public is able to tolerate in this matter, and I'm just idly musing on how much more it will take to pass that final line where protesters firebomb offices of insurance companies. It happened with some bank branches, didn't it?

[Darth Wong]

I'm astounded at the amount of abuse the American public is able to tolerate in this matter, and I'm just idly musing on how much more it will take to pass that final line where protesters firebomb offices of insurance companies. It happened with some bank branches, didn't it?

Unfortunately, as I mentioned earlier, there's an incredible amount of cultural resistance to some of the ideas we're putting forward here. Rising up against the insurance companies requires (in part) an admission that America has been the foolish laughingstock of the first world when it comes to public health. How many Americans can put down their flags long enough to admit that?

[The Duchess of Zeon]

Or not, Mike:

Government Health Care has widespread support

WASHINGTON (Reuters) - Americans strongly support fundamental changes to the healthcare system and a move to create a government-run insurance plan to compete with private insurers, according to a New York Times/CBS News poll published on Saturday.

The poll came amid mounting opposition to plans by the Obama administration and its allies in the Democratic-controlled Congress to push through the most sweeping restructuring of the U.S. healthcare system since the end of World War Two.

Republicans and some centrist Democrats oppose increasing the government's role in healthcare -- it already runs the Medicare and Medicaid systems for the elderly and indigent -- fearing it would require vast public funds and reduce the quality of care.

But the Times/CBS poll found 85 percent of respondents wanted major healthcare reforms and most would be willing to pay higher taxes to ensure everyone had health insurance. An estimated 46 million Americans currently have no coverage.

Seventy-two percent of those questioned said they backed a government-administered insurance plan similar to Medicare for those under 65 that would compete for customers with the private sector. Twenty percent said they were opposed.

President Barack Obama and many Democrats in Congress have argued a publicly run healthcare insurance plan would increase competition and drive down the high cost of care at a time when the U.S. economy is mired in a deep recession.

Republicans argue a public plan would drive insurers out of business and lead to a government-run healthcare system.

Democrats in the U.S. House of Representatives suggested this week that all Americans should be able to get insurance regardless of medical history and that coverage should be mandatory for individuals and businesses.

The proposal, contained in the latest House draft of the healthcare bill, would create new insurance exchanges where people shop around for health coverage. Whether a government-run plan has a role in such an exchange has spurred serious political debate.

Republicans, the minority party in Congress, have proposed more modest healthcare changes, but lack the votes in the House or Senate to push them through or derail the Democrats' health reform drive. They have warned about the expected high cost of restructuring the healthcare system, projected at more than $1.5 trillion -- a huge expense for a nation carrying record budget deficits.

The Republicans also hope to gain traction by playing on fears a vast expansion of government could further hurt the economy and reduce the quality of medical care.

The poll found that people were uneasy about heightened government involvement in the healthcare sector, with 77 percent saying they were very or somewhat satisfied with the quality of their own care.

A total of 895 adults participated in the telephone survey, which was conducted from June 12 to 16 and had a margin of error of plus or minus 3 percentage points.

(Writing by Paul Simao; Editing by Peter Cooney)

The terrifying thing is the prospect that despite such widespread support, the crucial government alternative in the programme, may well not be implemented, making the existing system worse. But perhaps with this much support, Obama can drive through the system including a government alternative available to all. Note that 77 percent of all people say they were very or somewhat satisfied with their care--the problem with that, of course, is that 15% of the US population is uninsured and I can easily see another 8% of the populace falling into the category of the "marginally insured" more or less who live in scandalous policies like the ones described in this thread which are little better than no insurance at all. What kind of country leaves 23% of its population to suffer, and perhaps die? And considering American propaganda on the issue the actual figure of those facing serious deficiencies in their health coverage and treatment is almost surely higher, and they just refuse to believe it when talking to pollsters.

[Haruko]

Thank you for reprinting that, Ms. Marina. I have been collecting articles about the state of American health insurance, and there was an old one that I had to print my reprint of because the original page was down. Here is that article, titled "Americans Want Universal Healthcare" (from Wed., 7 June, 2006; URL in the opening quote tag):

WASHINGTON (AP) -- The federal government should guarantee that all Americans have basic health insurance coverage, says a committee set up by Congress to find out what people want when it comes to health care.

"Assuring health care is a shared social responsibility," says the interim report of the Citizens' Health Care Working Group, a 14-member committee that went to 50 communities and heard from 23,000 people.

The committee describes its recommendations as a framework. The recommendations don't say who would pay for universal health coverage or how much it would cost. The concept of government-guaranteed coverage runs counter to the Bush administration's position that consumers should bear more responsibility for their initial medical expenses.

The group's findings will be officially presented to the president and Congress in the fall, but first comes 90 days of public comment. The president will submit to Congress his response, and then five congressional committees will hold hearings.

Sen. Ron Wyden, D-Oregon, said he and Sen. Orrin Hatch, R-Utah, came up with the idea for establishing a group that would work outside of Washington to find out what Americans want. He said they were tired of years of gridlock on health care issues.

"We decided, let's try something else. Let's go to the public and give them a chance, not in terms of writing a bill, but let them provide a kind of general roadmap where the country ought to head," Wyden said.

Wyden said he will wait to hear the public's comments on the report before reaching any conclusions about the findings. However, some groups are already wary.

"It implies massive new funding sources, massive new laws would be needed," said Sarah Berk, executive director of Health Care America, an advocacy group that pushes free market approaches to health coverage. "We want universal access, but this report just pushes all the difficult problems onto somebody else's plate. It says government needs to do it all."

George Grob, the executive director of the Citizens' Health Care Working Group, said the group was not asked to say specifically how to get to universal coverage. However, the group did recommend that financing strategies be based on principles of fairness and shared responsibility. The strategies should draw on revenue streams such as enrollee contributions, income taxes, so-called "sin taxes" and payroll taxes, the report said.

"We're already paying for health care for everybody who gets it, including people who don't have health insurance coverage who are taken care of when they go to the hospital," Grob said.

The group's stated values and principals were as important as the recommendations, Grob said. Those principals said all Americans should have a set of health coverage benefits guaranteed by law. Those benefits should be "portable and independent of health status, working status, age (and) income," the report said.

Congress passed the bill creating the Citizens' Health Care Working Group in late 2003. The same bill created a prescription drug benefit under Medicare. Congress approved $5.5 million to fund the group's work, which began in February of last year. The group consisted of 14 members representing consumers, the disabled, business and labor, and health care providers.

[Pablo Sanchez]

Part of the reason left-leaning groups don't challenge the narrative is that it's such a hard-sell. Americans are neurotically predisposed to believe without question in certain dogmas such as the benevolence of the free market and the superiority of American uniqueness, and any challenge to this narrative would face both of those beliefs at once.

The sad thing is that there are aspects of this debate that aren't a hard sell at all, because we have the leaders of the health care industry admitting on tape that they cheat the American people. A while ago they promised to cut $3 trillion in costs over the next ten years; a responsible media would have asked where this money came from and how they could afford to write it off. The answer is that it came from cheating people with overcharging, unnecessary procedures, choosing more expensive procedures when cheap ones would do (like using name-brand medication instead of identical generics, and other boondoggles. Then comes this story, when the same executives say that they intend to continue using minor errors made in good faith to cheat Americans out of their coverage when they most need it, to further pad their profits. That stuff doesn't meet the legal definition of fraud, but Americans will still know a con when they see one. Aggressive media coverage of this matter would whip up the public pretty quickly, but they simply aren't doing it. Part of it is that the kind of people who determine what ends up on the news (star reporters, producers/editors, etc.) are the same kind of people who have good health coverage, so the story just doesn't hit home for them. But I think it is more to do with the amount of advertising money that comes out of health-care related industries who don't want a public plan, especially pharmaceutical companies who are probably shitting themselves over the idea of a government health insurance plan that is actually allowed to negotiate for better prices on meds. It wouldn't be the first time that the hard-nosed reporters lost their balls over ad threats.

[Alyeska]

The free market will let a man die if he cannot afford to pay for his health care. The free market isn't about providing health care. Its about profits for the owners. I still cannot see how people think that a free market health care system is good for the people as a whole. It only benefits those rich enough to afford it. And of course the most vocal opponents of changing the system are those who reap the biggest benefit from it.

[Pablo Sanchez]

I still cannot see how people think that a free market health care system is good for the people as a whole.

The mainstream American media are total shit and are completely unable to sustain a serious critique of the American system, for a lot of reasons, each of which could have volumes written about it:

• Advertiser pressure, which can prevent them from engaging stories that would be financially injurious to their underwriters.
• The need to secure ratings/subscribers via sensationalism, which results in more prevalent phenomena being reported less and more exceptional events being reported more, so that reality is distorted and inverted.
• The desire to attract and maintain an audience drawn from "useful" demographics which leads to under-reporting of minority and poverty issues and overemphasis on white middle class issues.
• Editorial pressure from businessmen owner/publishers who, whether conservative or liberal by inclination, support the status quo by their nature because they have done well for themselves; successful and influential media personalities would tend to support the status quo for the same reason.
• Criticism from media observers who are quick to label substantive critiques as shrill, unserious, or anti-American.
• The media and its representatives have become increasingly compromised and co-opted by their subjects to the point of incest, due to proximity, the lust for insider access, and the natural tendency to identify oneself with the powerful. (This is most pronounced in financial media, and I would opine that the rough-and-tumble sports world is, hilariously, the least compromised by incestuous).

And more stuff I forgot at the moment. Basically, they're asleep at the wheel.

[Starglider]

[*]Advertiser pressure, which can prevent them from engaging stories that would be financially injurious to their underwriters.

I don't know how much airtime health insurance companies buy; I don't remember seeing any adverts for that when I was in the US. I do remember an endless stream of idiotic 'Omicure is a miracle drug. Look at these smiling, happy, soft-focus people, all thanks to Omnicure. Ask your doctor if Omnicure is right for you - (and if he says no, demand it anyway)'. Public healthcare will force down drug prices, so I guess pharma companies may be threatening (subtly) to pull their adverts from any networks that cover this.

[Pablo Sanchez]

I don't know how much airtime health insurance companies buy; I don't remember seeing any adverts for that when I was in the US.

Occasionally but not often. It's drooped considerably since the recession, probably because most Americans are locked into whatever their current plan (or lack thereof) is by economic uncertainty. My list of items was more in the character of a general overview of why the American media sucks, so not all of them bear directly on the point at hand--when I said the media couldn't critique the "American system" I meant the whole thing, not just the health care system.

I do remember an endless stream of idiotic 'Omicure is a miracle drug. Look at these smiling, happy, soft-focus people, all thanks to Omnicure. Ask your doctor if Omnicure is right for you - (and if he says no, demand it anyway)'. Public healthcare will force down drug prices, so I guess pharma companies may be threatening (subtly) to pull their adverts from any networks that cover this.

Indeed, pharmaceuticals are probably the most heavily advertised commodity on television today. We know where the pharmacorps come down on the issue of public health because of their behavior a few years ago when medicare prescription drug benefits came up for a vote; they lobbied intensely and succeeded in forcing a provision under which the new medicare service could not negotiate for better prices, which is totally insane. I doubt they could pull it off again, especially with costs playing such a big role in the debate already.

[Stark]

The prevalence of drug ads in America is very hard to imagine for someone from Australia; here, there are ads for common shit like Sudafed or flu crap or herbal nonsense, but I've NEVER seen an ad for ritalin, or any actual prescribed clinical drug. The idea that those sort of ads are common (and with a 'get your doctor to hook you up with this shit' bent) is bizarre to me.

[Xon]

The prevalence of drug ads in America is very hard to imagine for someone from Australia; here, there are ads for common shit like Sudafed or flu crap or herbal nonsense, but I've NEVER seen an ad for ritalin, or any actual prescribed clinical drug. The idea that those sort of ads are common (and with a 'get your doctor to hook you up with this shit' bent) is bizarre to me.

It's actually illegal in Australia to advertise most prescription drugs. The US-Australia "free trade" agreement slashed the hell out of a lot of those laws however.

[Stark]

Yeah, I remember that being discussed back in the day (the term 'free trade' being applied to the agreement is extremely amusing), but it's difficult for me to even imagine watching TV and having an ad for some prescription drug show up with pretty white people demanding I get some.

[Wing Commander MAD]

It not just television either. Every news magazine carries pharma ads as well. I would say that 4/5 ads in NewsWeek or US News & World Report are pharma ones. Not that I actually subscribe to them, its just what doctors seem to have those ones most in their offices along with womens magazines (which also have lots of pharma ads). Of course I probably won't reading them anytime soon now that I am uninsured, as I was on an extended student coverage through my fathers health insurance until recently(to give you and idea I graduated on the May 16 and I believe they dropped me on the 15; yes, I was uninsured and left to the proverbial wolves by I believe Blue Cross Blue Shield before I even had the degree in my hand), of course from the sound of it, health coverage will be a major issue during his upcoming contract renegotiation this fall (he works for the township sewer authority). So from an as of now newly unemployed and uninsured person I can say that this issue as at the forefront of my political concerns.

Seriously, I wonder how many thousands/millions of newly uninsured there are in the US now that I beleive most highschool and universities/colleges have just graduated the class of 2009? I imagine its going to be high even if most of the college grads are gainfully employed, seeing as getting health coverage anymore is damn hard from what I hear and college loans need to be paid off (not even considering those going to grad school and the seriously shitty situation they'll be in). On the other hand this may result in enough young angry uninsured people nationwide to get something passed.

[Netko]

Democrats prove yet again that they have no spine at all:
(sorry for no link, its being posted all over the place as an AP story, but I couldn't get a clean source googling for it)

WASHINGTON – Key Senate Democrats, bidding for bipartisan support on health care, pared back subsidies designed to make insurance more affordable on Thursday and floated a compromise that rules out direct government competition against private insurers.

Despite the cost-cutting, the proposal backed by Sen. Max Baucus, chairman of the Senate Finance Committee, requires most individuals to purchase coverage and forbids insurance companies from denying it on the basis of pre-existing medical conditions.

The brief outline did not specify how the government's costs would be covered, although Baucus and many Republicans favor a tax on certain employer-provided health benefits. The Montana Democrat has said he intends to hold the cost of the legislation to about $1 trillion, well below the $1.6 trillion estimate the Congressional Budget Office made of an earlier set of options.

Across the Capitol, Democrats on the House Ways and Means Committee privately circulated a list of possible tax increases to pay for expanded health care.

They ranged from raising the Medicare tax, slapping a 10-cents-per-can increase on sweetened drinks, raising the alcohol tax, imposing a new payroll tax on employers equal to 3 percent of their health care expenditures and taxing employer-provided health insurance benefits above certain levels.

Also under consideration was a value added tax, a sort of national sales tax, of up to 1.5 percent or more, with housing, education, financial services and medical care potentially exempt.

House Democrats were expected to unveil an outline of their own to expand health coverage on Friday, although several officials said they did not plan to include mention of the tax increases under consideration.

Taken together, the developments reflected an eagerness by congressional Democrats in both houses to meet a self-imposed deadline of having health care legislation to the floor of both houses of Congress by summer. President Barack Obama has made the issue one of his top priorities.

Neither the Senate Finance Committee outline nor the list of tax options under review by House Democrats was made public. The Associated Press obtained copies of both.

"There's no doubt in my mind we're going to get a bipartisan bill," Baucus told reporters as he emerged from a meeting with a small group of Republicans he referred to as a "coalition of the willing."

The senior Republican on the Finance Committee was not nearly as bullish.

"I'm still at the table. I wouldn't be at the table if I didn't think there was some hope for it," said Sen. Chuck Grassley, R-Iowa. "But tomorrow it could be an entirely different story."

According to a 10-page outline that described the proposal, federal subsidies would be available to help families up to 300 percent of poverty, or $66,000, purchase insurance. An earlier proposal set the level at 400 percent of poverty, or $88,000.

At the same time, the new outline could require higher out of pocket costs from individuals because companies would be permitted to offer policies that cover less of an insured's anticipated medical costs than was earlier proposed.

Many Democrats want the government to be able to offer insurance in competition with the private industry, a provision they say would hold down costs. But most Republicans are opposed.

The outline presented at meeting with Republicans left the matter open, but suggested creation of nonprofit co-ops to offer insurance, rather than the government. The co-ops could accept federal loans for startup operations, but would have to repay the money.

Similarly, the outline leaves open the question of requiring larger employers to provide insurance.

As an alternative, it suggests requiring companies to pay a portion of the cost of insurance for lower income workers not offered coverage at work.

While Baucus supports a tax on health benefits, Obama opposed it in last year's presidential campaign and attacked his rival, Sen. John McCain, R-Ariz., for proposing it.

Administration officials have refrained from criticizing it in recent weeks, but organized labor is opposed, fearing it would mean higher taxes for some of its members.

Congressional aides say Democrats are eager to exempt union contracts from the proposed tax, but Republicans want to include them. In its most recent form, the proposal would impose a tax on plans in which the combined employer and employee premiums are above about $17,000.

That would raise an estimated $270 billion over a decade, less if union-negotiated plans were exempt.

Yup, the Dems are caving and are offering up a plan that would be the worst of all worlds (mandated insurance with one of the current health "insurers" plus a tax increase), and which would probably lead the already ginormeous US health care spending skyrocket.

The only two good things about this proposal would be that it would force insurers to cover people despite preexisting conditions, and that it would cover the uninsured. Even in both of those cases, considering the spinelessness of the bill, it wouldn't surprise me if there are massive loopholes and huge cracks for people to fall through. For example, they already lowered the ceiling for assistance with insurance payments, and the Republicans still aren't on board - if they force more concessions, the final bill might have the effects of again cementing underemployment of the poor for fear of falling into a healthcare nightmare if they earn too much, except this time that nightmare would not only be a lack of health insurance, but also the threat of fines if you don't buy the insurance that you can supposedly afford.

All in all, good luck to our American posters, I really hope this doesn't pass.

[MarshalPurnell]

Wonderful, just bloody wonderful. Congress passes a compromise which will just make things worse. Whoever could have imagined such an outcome? Undoubtedly the Democrats are terrified that their Blue Dog contingent will defect over to the Republicans if they try to pass a public insurance option. Nor does Obama seem willing to throw his influence at the bully pulpit behind a broad-based campaign to change the political dynamics of public health care. For myself I'd rather Congress do nothing than pass something as critically stupid as mandatory health insurance without touching the bloated, sprawling and corrupt private model of providing it.

[Balrog]

The prevalence of drug ads in America is very hard to imagine for someone from Australia; here, there are ads for common shit like Sudafed or flu crap or herbal nonsense, but I've NEVER seen an ad for ritalin, or any actual prescribed clinical drug. The idea that those sort of ads are common (and with a 'get your doctor to hook you up with this shit' bent) is bizarre to me.

Sometimes they don't even bother telling you want the drug is for, just images of happy smiling people having fun outside on a bright sunny day while the announcer tells you to go ask your doctor if you need [insert drug name].

[Lord MJ]

So my conservative friend had something to say about this.

He suggested a private non profit that the government initially invests $100 mil into and then the government stays out of the picture after that...

And he was complaining that universal health care would require responsible citizens to pay for people that have made unhealthy decisions, and they shouldn't have to do that...

I for one don't see how a $100 mil funded non profit will solve anything..

[The Duchess of Zeon]

Wonderful, just bloody wonderful. Congress passes a compromise which will just make things worse. Whoever could have imagined such an outcome? Undoubtedly the Democrats are terrified that their Blue Dog contingent will defect over to the Republicans if they try to pass a public insurance option. Nor does Obama seem willing to throw his influence at the bully pulpit behind a broad-based campaign to change the political dynamics of public health care. For myself I'd rather Congress do nothing than pass something as critically stupid as mandatory health insurance without touching the bloated, sprawling and corrupt private model of providing it.

Well, those health insurance co-operatives might work, especially in this area--but what the fuck are people who can't get on Medicaid/Medicare do to pay for insurance? Where are they going to go for it? Will these subsidies in fact remotely make insurance really affordable, or is this just the federal government forcing people to get in debt to keep the wheels of commerce turning?

No, I finally have to admit it's true, the democrats are not a left-wing political party.

[The Duchess of Zeon]

Anyway unless the House can force a better compromise that includes a public option, this decision simply guarantees that the situation of public health in America is about to get substantially worse.