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15 January 2010

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Andy

This is what happens when legislation passes by the barest of majorities in both the House and Senate - it leaves very little room for compromise in reconciliation since every vote counts. Since there are some major differences between the bills, it is difficult to satisfy everyone to ensure they will vote yes on the compromise - it may even be impossible.

Legislation with broader support can be reconciled quicker because a few lost votes will not sink the reconciled bill.

R Whitman

A really screwed up bill will pass soon. Look for it to be greatly modified over the next 20 years until it is done right.

Social Security was passed in the 1930's, in the late 1940's self employed persons were added, in the early 1980's it assumed it present form.

Medicare was passed in the 1960's, and modified in the 1980's. It assumed its present form in the 1990's if you do not count Part D, the drug benefit which is under revision right now.

We can expect many revisions to National Health Insurance to make it workable, but the important thing is to pass it the first time.

For those young Republicans in the House of Representatives who have Presidential ambitions in the far future, a party line vote against this could be the kiss of death. Robert Dole, the Republican Presidential candidate in 1996 lost many senior votes because he had voted against Medicare when he was a House member in 1965.

Bill Wade, NH

Martha Coakley (D) Mass must be getting desperate, non-stop ads on the local networks and I hear President Obama will be campaigning for her this weekend.

"With all due respect," Brown shot back, "it's not the Kennedys' seat. It's not the Democrats' seat. It's the people's seat." Scott Brown, Republican

I'm predicting a Brown win.

I think President Obama only understood who the people were voting for and not what they were voting for.

William R. Cumming

This is not going to happen before Mass Senatorial election which by the way has several minor party candidates including one named Kennedy.

The peasants may be sharpening their pitchforks first at the voting booth.

Patrick Lang

WRC

How long after the election will the new senator take office? pl

Wellescent Health

Undoubtedly, the Democrats are in a race to avoid a reset of sorts on their health reform bill. Though the bill will, by no means, be perfect, it must be considered a starting point on which to base ongoing reforms that will rarely ever get media attention. It is sad however, that the Republicans decided early on not to support reform and instead decided to turn reform efforts into a political debate. Such tactics really do little to serve the American people.

dws

Andy,

The legislation passed the Senate with 60 votes, not really the "barest of majorities". However, 60 votes is what it takes these days. I have watched this become the norm over the last 30 years.

Mark Logan

Very good question. Why?

Could be they are pushing hard, but keeping it as quiet as possible so as not to give the Republican candidate something to crow about and to insure that
Democrats feel a need to turn out.

If they announced that the
HC bill was a done deal before Tuesday, seems likely there would be fewer Democrats who would bother to show. Especially for a marginal candidate.

That is of course a guess.
I can't imagine them not feeling a bit of panic.


Jose

Upset, Coakley wins because the Boston political machine will not allow a loss.

Look for dead people voting...lol

GulfCoastPirate

The bill should die. It's a horrible bill. Those who are buying into the idea it can be 'fixed' in the future are, IMHO, completely wrong. It was a corporate written bill by a corporate dominated government. The 'fixes' will almost certainly be worse. The only fix for health care is single payer. There is no other way you can cram down the percentage of GNP spent on health - which is the real problem.

It may be good if Obama and the Democrats lose the seat in Massachusetts. Then we'll see what he is made of and who he really wants to represent. If Rahm, Sumner and Geithner are still around after the loss then you can count on things getting a lot worse. I read somewhere last week that 40% of all profits of all US publicly traded companies on Wall Street were from the big Wall Street banks. That's not capitalism and people will never be put back to work. Thats nothing more than a transfer of wealth from the middle and lower classes to Wall Street.

I own a business. I deal with other small businesses. I have friends who are both workers and business owners. No one who is still eligible to borrow to expand or consume is doing so. Everyone is hanging loose. Obama was elected to move left. Get out of Afghanistan, get out of Iraq, cut the Israelis loose if they don't want to make a deal - cut military spending overall. Cut out the corporate cronyism in DC. He's done just the opposite. If they lose this election and we still see Rahm and his boys around then no one is going to do a single thing to expand since there won't be enough capital around to put people back to work so they can begin buying again.

Dealing with health care before they dealt with financial reform on Wall Street was a big mistake.

greg0

The only reason Health Care Reform is threatened by a Senate election in Mass. is because of Senator Harry Reid's interpretation of Senate rules. Will the Senate become a legislative dead-end when a few more Democratic Senate seats are lost in 2010? Just the threat of a filibuster will stop the process?
No controls on the cost of health insurance and penalties for not buying it is a combination guaranteed to disillusion the Democratic base. So what is Obama thinking???
It's going to be a tough sell, whatever passes. Much easier to talk about the party of NO.

DE Teodoru

No rush on the healthcare bill as it will be as good as our war on terror is. My dad considered it his greatest accomplishment to be elected as a Fellow of the American Academy of Medicine. Such doctors of his generation put "MD, FACP" next to their names on prescriptions, calling cards and stationary in pride. In my generation, doctors did a five years residency specialized in "Family Practice" with 6months training with residents in each branch of medicine and surgery. In my daughter's generation they call internal medicine of 3 and 1/2 years residency and Family Practice of 5 yrs of residency "PRIMARY CARE," supposedly serving as gate keeper that steers patients to specialists. In my dad's days such a primary care guy only had a year of internship so the "internist" was the real science&art doctor who took care of THE WHOLE PATIENT. Now he's just dumped on by the big fee lazy specialists. It's all a business, if not a racket. Imagine that you go to a specialist and he prescribes something and if you don't feel better or think you're having a drug reaction he tells you to go see your "primary care." What's he going to do, change the specialist's prescription?

Then there are the tests. A VAP lipoprotein profile will cost you $350 through the lab your doctor uses. But all the labs send the VAP test to be done at one lab in Alabama. If you contact that lab, you can send them the blood and it costs $40 for a VAP test. Why to CAT scans and MRIs cost so much? Why are such radiological systems businesses for doctors rather than services for patients?

So in the future, in Obama's plan you'll see a Physician's Assistant as your primary care and, until you get in the hospital you won't be tested as needed because only hospitals get paid for days of stay plus the work done. There are crooks that rent a mailbox, buy a bunch of social security numbers of people on Medicare and proceed to bill Medicare for devices. Three months and $4 million later they close shop and create another supplier POBox and start billing again. Hundreds of millions are stolen that way. Will Obama stop such fraud? The answer is obvious given that YOUR health is someone else's for-profit business. That's like cannibalism, where the young, old and infirmed get eaten!

Meanwhile all the wonders of the new molecular medicine are totally beyond the current healthcare because who is going to expose his genome to an insurance system that punishes prior condition? Genetic predisposition by marker will be just that!

Iraq/Afghan Wars were criminal wars, not just because we killed a lot of people indiscriminately, but because 53% of our war expenditures are *FOR PROFIT* corporate operatives and so were a boondoggle. Since Bush, Americans have been robbed blind, if not killed in service. so what's the rush? His ultimate goal is "down-pointing" medical costs anyway, not expanding services. I guess to expect more from a healthcare bill than we get from the folks who gave us a failed Pentagon makes no sense. Please be sure your kids learn Chinese so they can at least earn a living working for our soon to be masters

Richard Armstrong

Way back the early 80's then SeaFirst became the first "national bank" the script for what was to come was written.

"To Large too fail" is more correctly described as "To large to be regulated".

The American people are well and truly ("what one does to a wood screw") by the banks that are actually more powerful than our government.

As long as they are allowed to be "national banks" they will have the funds to provide irresistable campaign donation to the people whom provide minimal representation to the people that elect them.

This is a situation that cannot be rectified.

Yes. I am a pesimist.

Adam L Silverman

Sir,

Its a special election to fill the empty seat for the rest of SEN Kennedy's original term. As soon as the election is certified she'll be seated in the Senate.

The larger issue here, the one of process, which has been excellently documented in a number of other places has much to do with the compromises by the Framers that led to very poor institutional design of America's political structures. The minoritarian friendly rules of the Senate, when put in the hands of a group that see the political process of legislating or administrating as pure politics you get a zero sum game. What is good for America or Americans is no longer the point, rather the process is subverted in the pursuit of power for the sake of having it. While our system would still be institutionally weak, it would function much better if the minority/opposition party was actually making an effort to actually fulfill that role rather than just saying "no" to everything and responding with the same two proposals: cut taxes and deregulate. You do have to give them credit for holding their caucuses together in a unified manner, the leadership is quite impressive, but it has completely gummed up the response mechanism just when we need it most at a time of crisis.

So it should not be surprising to anyone that not a single nation-state that we've helped rebuild since WW II has borrowed our system. Not the Germans, the French, the Japanese, the Iraqis, or the Afghans. Some of our features are borrowed; federalism or a president, but not the system as a whole.

The other big issue here has to do with the differences both in the parties and their legislative and leadership styles, but also in how the Obama Administration has handled this. In the case of the former you have some delegates that are responsible party members, both in the House and in the Senate, and a few that feel no compunction to maintain the whip for even procedural issues. Moreover, no one seems to put pressure on them. As a result you get the behavior we see from SEN Lieberman or SEN Nelson or SEN Lincoln or SEN Bayh. And the fact that the Senate Finance Committee, which was 1) not supposed to actually write the bill, but rather take the other two committees' bills and come up with a way to pay for them (that's its actual job for things like this, not writing specific legislation covered by other committees), 2) is composed of senators from the least populace states. As a result senators from states representing fewer Americans than live in just my home state of FL are dictating what over 90% of Americans will receive, and 3) the states they represent overwhelmingly receive subsidies from the more/most populace states; so when the revenue pie is divvied up those of us who live in NY, PN, CA, FL, etc are subsidizing NB, IA, AR, etc. This is a trade off of being a citizen, but the carping on fiscal rectitude by people whose constituents reap far more benefits from my tax dollars than I do is a bit much.

Finally, the White House has completely mishandled the IO and PsyOps on this, as well as on the stimulus. While they do have to work with the Congress, and all the constraints that that creates, their message, policy, and politics team has been HORRID! If you have gauged the legislative branch and know you can't get some version of single payer through (and I'm being agnostic right now on what I think is the best system, though I'm willing to openly admit our system is broken and needs fixing as its destroying our economy), but you want serious reform and a public option to compete with the private ones as a check on what the insurance industry has become, then you don't make your initial proposal the public option as the farthest out starting point because you've got nowhere to bargain to that doesn't automatically lead to a policy debate where you have to scrap what you actually want. The White House should have rolled out with single payer if they were really going to aim for a public option, they didn't which leaves one to wonder did they really not want that either? And the IO and PsyOps on the constant distortions about what is actually is in the legislation, warts and all, has been poor too. The response to the rationing canard should have been "we've already got rationing, its done by a bean counter at your insurance agency!" or "would you rather have health care experts determine what makes sense for treatments or someone with a bachelor of business admin at a call center at your insurance company?" None of this was done and the result was that Administration committed IO fratricide.

McGee

Hi Pat,

If he wins on Tuesday he could be sworn in on Wednesday, unless the results are contested.

And I'm beginning to think he might win, although he's an airhead and a total corporate tool. Sad, really, and totally Coakley's fault. Don't think Massachusetts has ever had a senator like this. We've had a few Republican Senators here before, most recently Edward Brooks, and they've always been highly qualified legislators we could be proud of, even if we disagreed with them on certain issues.

Not this one....I know people who know him well and all I can say is prepare for the worst.

jonst

Win or lose, closely (and the talking heads on Sun/cable will determine what "closely" means) the Dems, and the MSM will draw the wrong conclusions. But it is the only conclusion they ever draw regardless what the issue is: The Dems must move to the "Center". To the extent the word "Center" still had it traditional meaning, this might be a good thing. However, moving to the "Center" these days means giving more power to corporations. And corporations don't want to limit govt spending....they want to increase it, and redirect it. To corporations. And THIS dynamic is the driving force of our so called National Security Policy.

john in the boro

As near as I can tell, the locals have 10 days to tally absentee ballots and certify the results, 5 more days to submit the results, and the MA Sec of State then certifies the result. He forwards the certification to the Senate which sets up a swearing-in at the convenience of the VP. So, if Brown wins, things could move slowly in MA and in the Senate thus preserving acting Senator Kirk's vote for the Dems. The 60 seat dem majority looks safe until the SoU speech. Does that mean passage of the bill?

Patrick Lang

Adam

As you know the US federal system was designed as a series of compromises to protect a variety of regional and other intersts. Nothing has changed that and nothing will change it. pl

lina

Yes, they can pass the bill if Coakley loses.

"[Mass.]Secretary of State William F. Galvin, citing state law, says city and town clerks must wait at least 10 days for absentee ballots to arrive before they certify the results of the Jan. 19 election. They then have five more days to file the returns with his office."

http://www.washingtonpost.com/wp-dyn/content/article/2010/01/13/AR2010011302542.html

Of course, it's still all up to Joe Lieberman (D- Aetna).


VietnamVet

Colonel,

I agree 100% with GCP. The Health Reform Bill is just a patch job by politicians to allow their cash contributors to continue scamming the ill for a few more years. It forces the young and healthy with jobs to pay the insurance companies for coverage and taxes employer health insurance plans but does not provide coverage the uninsured or real cost control.

The lack of true reform of the banking and health system by the Obama Administration assures a bigger crash sometime in the future, maybe in my lifetime, but assuredly within my sons.

Andy

The issue, as is the case with so much in America these days, is a lack of political consensus.

While it's easy to blame the party of "no" for obstructionism, one also needs to consider that the Democratic leadership is finding it very difficult to reconcile the competing interests of their own party. A bill that's too "moderate" will cause the liberals will jump ship and, similarly, moderates won't accept a "liberal" bill. In this calculation the GoP is mostly irrelevant which seems to suit the Democrats just fine.

The hoops the Democratic leadership jumped through to gain passage is impressive, but also troublesome - and not only because support was so blatantly bought in several cases. The concern I have is that legislation this far-reaching and enduring needs more public and political support than what we are seeing. Contrast this with other landmark legislation such Social Security, Medicare, and the Civil Rights act, all of which were overwhelmingly passed and still enjoy wide and deep popular and political support.

A bill barely forced through Congress on the basis of vote-buying and arm twisting which has questionable popular support (at least according to polls) will likely be unable to stand the test of time without at least major revision. Personally, I don't buy the argument some make that it's important to get something - anything - passed now with the intention of fixing it later - that's bad governance in my opinion.

Mark Logan

A bit more detail on why it will be difficult to rush.

http://www.huffingtonpost.com/2010/01/15/a-brown-win-could-kill-he_n_424910.html

The nutshell:

A big problem is that the compromise bill, the one that results from the melding of the House and Senate bills, has to go to the CBO. That eats up ten days or more.

Plan B would have to be either the House or the Senate bill. Either one could be voted on before Brown could be seated.

optimax

I don't understand why Joe Lieberman is agianst U.S. universal healthcare, after all a state he represents has it-Israel.

different clue

Optimax,

The reason Senator Lieberman is against U.S. universal healthcare is because an industry he represents- the private health insurance industry- is against it.

Harper

The bottom line is that many Democrats in both the House and the Senate know that the bill is crap, as it is likely going to come out of the White House negotiations. The bill will slash payments to Medicare, will create an independent board that will be empowered to slash costs (the White House wonks call it "bending the cost curve"), with no Congressional oversight. They had the audacity to add in totally unconstitutional bans on any future Congress changing the independent commission elements of the bill. The Republicans in Congress know that there are many Democrats who adamently oppose these measures, and there are many Democrats who wanted a single-payer system (extend Medicare and Medicaid to all). The Republicans, who were otherwise lost in the wilderness, have seized on these disasterous features of the health care bill, and are going to make big gains. Democrats in the House and the Senate are fearful that their polling numbers will fall by 10 points, the instant they vote for the bill. Some are so pissed that they are throwing in the towel and not running for reelection. Witness Vic Snyder this past week. Rep. Neal (D-Mass.) has over 100 colleagues signed on to a letter, demanding that the independent commission be struck from the final version of the bill, but the White House says that they will not accept any bill that removes the commission. Rep. Joe Courtney (D-Ct.) has well over 200 signatures on a letter opposing any bill that has the "cadillac tax" included. Do the math. The Congressional Democrats see this bill as a kiss of death.

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