I sent an email to Eric Massa some time back, thanking him for voting against HR 3962, and specified that I didn't need a reply, as I'm not one of his constituents. I got a 'form letter' response anyway, and thought I would share it.

Dear [hipparchia]:

Because you have previously been in touch about health issues, I am writing to let you know why I voted "no" on the 2009 major health care reform bill (H.R. 3962). Being accountable to you for my actions, perhaps you will forgive a detailed response.

Words cannot express the relief I feel at not having to read yet another access blogger's "progressive" screed on Senate process. Now, about the sausage?

First, phantom reform does give you choice, but it is the choice between many HMOs and other private, for-profit insurance plans. Real reform would give patients the choice they actually want, which is to choose their doctors and hospitals. Americans don’t want a choice of insurance company bureaucrats; they want a choice of health care providers.

That's the sting in the tail of this Golden Sacks report quoted at HuffPo. To GS, though status quo is best* (bien sur), the Senate Finance Bill is the "base" scenario, a watered down version of it the "bull" scenario_{MR SUBLIMINAL No shit} and the HR 3962 is the "bear" scenario. But remember the baseline on financial reform? That if the banksters aren't threatening to commit suicide, the reforms are too weak? Same here. If GS isn't saying the bills are the end of the world, they're too weak.)

A Goldman Sachs analysis of health care legislation has concluded that, as far as the bottom line for insurance companies is concerned, the best thing to do is nothing. A close second would be passing a watered-down version of the Senate Finance Committee's bill.

Haw.

A study put together by Goldman in mid-October looks at the estimated stock performance of the private insurance industry under four variations of reform legislation. The study focused on the five biggest insurers whose shares are traded on Wall Street: Aetna, UnitedHealth, WellPoint, CIGNA and Humana.

The Senate Finance Committee bill, which Goldman's analysts conclude is the version most likely to survive the legislative process, is described as the "base" scenario. Under that legislation (which did not include a public plan) the earnings per share for the top five insurers would grow an estimated five percent from 2010 through 2019. And yet, the "variance with current valuation" -- essentially, what the value of the stock is on the market -- is projected to drop four percent.

Things are much worse [that is, better for people who need health care], Goldman estimates, for legislation that resembles what was considered and (to a certain extent) passed by the House of Representatives. This is, the firm deems, the "bear case" scenario -- in which earnings per share for the top five insurers would decline an estimated one percent from 2010 through 2019 and the variance with current valuation is projected to be negative 36 percent.

What the firm sees as the best path forward for the private insurance industry's bottom line is, to be blunt, inaction.

The study's authors advise that if no reform is passed, earnings per share would grow an estimated ten percent from 2010 through 2019, and the value of the stock would rise an estimated 59 percent during that time period.

And now, here's the sting:

audio by title hoosiers for a commonsense health plan single payer now

Senator Bernie Sanders:

In my view, the real solution to the problem of how to reform health care in this country is a Medicare-for-all, single-payer system. We are going to try to at least give states the option to go forward and move toward a single-payer system. Whether it’s Vermont or somewhere else, if one state pulls it off it will spread around the country.

Nothing. PNHP's Oliver Fein:

Insurance companies play no constructive role in providing health care.

They do not give you a physical exam; they do not perform your surgery. What they do instead is fight claims, issue denials and screen out the sick, diverting huge sums away from much-needed care.

The savings rendered by cutting out private insurance companies and establishing a single-payer plan would be sufficient to cover everyone who lacks insurance now and to upgrade insurance for everyone else.

Our nation spends twice as much per person on health care as other industrialized countries do, but our health outcomes are significantly worse.

Jonathan in comments at the sideshow:

Prediction: If the senate passes the health bill, the public option will devolve into a dumping ground for sick people that the private insurance companies don't want-- which is one of the reasons the bill doesn't kick in right away-- to give them time to thoroughly comb through their lists to cull millions of us from eligibility before they supposedly won't be able to any more.

Haw. Why am I never cynical enough?

On a separate thread where folks are discussing possible legal challenges health care bill, I said I'd look around to see if there have been any challenges to Massachusetts mandatory coverage law and how they fared. This is by no means comprehensive:

Mass.
Against the Mass. law, I could find only one challenge and that was thrown out on what seem to be procedural grounds rather than on the merits. (I can't find the slip op. online to confirm).

Tea Party Challenges

Who knew? But it's nice to see it all put together:

REP. DENNIS KUCINICH: Because it’s not the best we can do. It mandates people purchase private insurance. It is a $70 billion giveaway to private insurance companies and locks in this system that’s the problem, not the solution.

David Jenny writes* in the Bangor Daily News:

The president and Congress agree: Washington’s solution to 46 million uninsured Americans is to “mandate” that they all purchase health insurance from private companies, or — if the president’s view should prevail — a government-run “public option.”

Until now, our federal government has never claimed the power to compel individual citizens to pay insurance premiums to either private companies or government entities.

Astonishingly, no one is asking: “Does the federal government actually have the power to dictate that individuals purchase health insurance?” ....

All Eyes Are on Pennsylvania

Name sponsors of the legislation, Senator Jim Ferlo (D) and Representative Kathy Manderino (D) were joined by co-sponsor Representative Bill Kortz (D) in delivering impassioned messages to the rally attendees.

Billed as the keynote speaker, Sen. Ferlo expressed his passion oratorically and physically, pounding the podium for emphasis with such gusto he nearly sent two CS2 cassette recorders flying. He spoke of inclusiveness, advising, “Don’t write anybody off as we build this movement.”

This is a copy of the long reply that Maggie Mahar made to my post "Why Is Maggie Mahar Lying About Health Reform?" at TPMCafe. I've now gone through in turn and posted responses to her statements. I will not have time to do another round of replies, but hopefully this will be enough. I suggest that people show up to the Firedoglake book salon on November 9 and ask her to stop saying that the public "option" is anything at all like "Medicare E (for everyone)."

I am, of course, not lying about Health Care reform.

Samuel Metz in the Oregonian:

Smoking kills. So does the health insurance industry.

In the 20th century our tobacco industry, threatened by associations between its product and a lung cancer epidemic, diverted public discussion to a multitude of highly charged and largely irrelevant issues. It succeeded so well that even now, 50 years later, it still freely markets its dangerous products with only minor packaging concessions.

On November 9, Maggie Mahar is doing a book salon at Firedoglake on her book Money-Driven Medicine. I think it probably contains many useful facts, and even decided to order it last week from Amazon. For example, it correctly points out that the largest problems in the American health care system today are unnecessary procedures and overpayment for services. However, I now know that I will need to closely scrutinize its every word before accepting it as true. Why will it be hard to take this book at face value? Because Mahar has lately engaged in a complete flight of fancy about the proposed "public option."

I just wish "public option" advocates could figure out what to call whatever it is they're advocating. Leader Pelosi:

Ms. Pelosi said the public plan, which she prefers to call a "consumer option," would compete with private insurers. But the speaker was apparently unable to muster the votes needed for the 'robust' liberal version of a public plan, which she has repeatedly said would save more money for consumers and the government.

Dammit! Now I've got to change:

[a|the][strong|robust]? [Federalist]? public [health insurance?] [option|plan]

to:

[a|the][strong|robust]? [Federalist]? [public|consumer] [health insurance?] [option|plan]

I mean, it used to be whatever else the ... "public option" was, at least it was public; that was the constant factor.

Versailles wants to continue to be consumers of for-profit health insurance, which delivers as much care as is consistent with as much profit as possible, as opposed to citizens for whom health care is a right. That's why Versailles, including our "progressive" access bloggers, took single payer off the table from the start. So, in a way, the honesty of "consumer" is a refreshing change from the dishonesty of "public."

Meanwhile, I think I know what to call it:

Via email, Mobilize for Health Care:

Dear Friend,
CALL PELOSI NOW! (415) 556-4862 and (202) 225-0100
There are 8 people sitting in RIGHT NOW in Nancy Pelosi's Office in San Francisco!

They are not leaving until they get an answer to their demands! Their demands are that the Kucinich amendment MUST be in the health care bill that the House votes on, and that the House MUST vote on the Weiner amendment.

Pelosi PROMISED the American people that she would ensure BOTH of the above would happen, and she has betrayed us by renigging on those promises!

While some Dems are joining with Republicans to try to prohibit even private insurers from covering abortions in the new "reform" effort, other Dems are joining with Republicans to ensure Christian Science Prayer sessions are covered by insurance:

Backed by some of the most powerful members of the Senate, a little-noticed provision in the healthcare overhaul bill would require insurers to consider covering Christian Science prayer treatments as medical expenses.

Daily Mail:

A secret court is seizing the assets of thousands of elderly and mentally impaired people and turning control of their lives over to the State - against the wishes of their relatives.

The draconian measures are being imposed by the little-known Court of Protection, set up two years ago to act in the interests of people suffering from Alzheimer's or other mental incapacity.

The court hears about 23,000 cases a year - always in private - involving people deemed unable to take their own decisions. Using far-reaching powers, the court has so far taken control of more than £3.2billion of assets.

The forced-birthers are out in force in the blogosphere, looking for federal funding of abortions in the bill, so I thought I'd help them out.

-------------------------------------------------------------------------------------------

The public plan and the exchange[s]

The public plan might or might not pay for abortions that don't fall under the Hyde amendment. The Secretary of HHS cannot require private insurance plans offered through the exchange[s] to cover abortions of any kind. Fortunately Sec HHS can't prevent private insurance from paying for abortions either. Abortion cannot be listed as part of the essential benefits package.

If you want to know why people might NOT want to choose the public plan, here's one reason that some women will "choose" to stay with private insurance.

Oh well, at least it doesn't prohibit abortion coverage outright.

Via ThinkProgress, both the Baucus Bill and the plan put forward by Pelosi will enroll some more people but most will not be in the Public Option and it will not cover everyone:

CBO: Public Option To Attract Only 6 Million Enrollees & Doesn’t Offer Lower Premiums

The public option would attract about 6 million enrollees by 2019 and charge premiums that are “somewhat higher than the average premiums for the private plans in the exchanges.” This is because the public option would “engage in less management of utilization” by its enrollees and “attract a less healthy pool of enrollees,” the office concludes. Moreover, since the House bill expands Medicaid up to 150% of the federal poverty line, it’s possible that the enrollees that would have enrolled in the public option went into Medicaid instead.

Below is a comparison of the relevant provisions in the House and Senate Finance Committee legislation:

	CBO Score Of House Bill	CBO Score Of Baucus Bill
Costs	Reduce deficits: $104B/10yrs Cost: $894B/10yrs Spends on subsidies: $605B/10yrs On Medicaid/CHIP: $425B/10yrs On Small Employer Credit: $25B/10yrs	Reduce deficits: $81B/10yrs Cost: $829B/10yrs Spends on subsidies: $461B/10yrs On Medicaid/CHIP: $345B/10yrs On Small Employer Credit: $23B/10yrs
Insured	Uninsured reduced by: 36M Uninsured in 2019: 18M In Exchanges: 30M | Public Plan: 6M In Medicaid: 15M	Uninsured reduced by: 29M Uninsured in 2019: 25M In Exchanges: 23M In Medicaid: 14M
Revenue	Mandate penalty: $33B/10yrs Pay-Play penalty: $135B/10yrs New taxes: $572B/10yrs	Mandate penalty: $4B/10yrs Free rider penalty: $23B/10yrs New taxes: $196B/10yrs
Medicare and Medicaid	Total savings: 426B/10yrs Medicare Advantage: $170B/10yrs	Total savings: 404B/10yrs Medicare Advantage: $117B/10yrs

With a Single Payer solution it would be everybody in and nobody out - AND it would save a heck of a lot more money for everyone.

The difference is not just everyone being covered but HUNDREDS of BILLIONS of DOLLARS saved every year:   Read more…

That's the kindest explanation I can think of.

Bloggeth the formerly-liberal perfesser a few days ago:

What this suggests is that the really important thing, for reformers, is to get the principle of universality established. Once that happens, there’s no going back.

Yeah, well, I guess it helps if you define universe.

is not the nut you think. Atrios points to this from Howard Fineman on Snowe ("What’s So Hot About Snowe?"). But here's the buried nugget:

[Snowe] remains deeply skeptical of a publicly financed alternative to private insurance, in good part because of what she sees as the failure of Maine's* version of the idea...

George Washington has another interesting guest post up over at Yves place: Capitalism, Socialism or Fascism? The bottom line:

So what do we really have: socialism, fascism or an economy which calls itself “capitalism” but which allows looting?

Ultimately, it doesn’t matter. They are just different brand names for the same basic type of economy. All three systems allow giant businesses which are friendly to the government to keep enormous private profits but to pass the losses on to the government and ultimately the citizens.

Whether we use the terminology regarding socialism (”socialized losses”), of fascism (”public and social losses”), or of looting (”left the government holding the bag for their eventual and predictable losses”), it amounts to the exact same thing.

I'd argue that any electoral politician* who doesn't make put this simple fact at the foundation of their thinking is doomed to irrelevance -- whether they're left or right. (The center is already irrelevant if Obama had his chance for an FDR moment, and blew it. We won't know whether that's true for awhile, but it sure feels to me like it's true.)

Interesting story that got no play in our famously free press or on the A list, though Hipparchia covered the wonky version of the story. This is the snarky version! From Wednesday of this week:

The nation's medical costs will keep spiraling upward even faster than they are now under Democratic legislation pending in the House, a report from government economic experts [but see below] concluded Wednesday.

The Obama administration immediately challenged the analysis...

Of course, of course.

SoBe is at it again, with another powerhouse common sense post. Be sure to check out the graph, although I suspect most of you have seen its like before. And this is not exactly unexpected, and I bet we'll see more of it:

Even more alarmingly, Putnam County, TN, is in such dire straights it has considered doing away with county primary elections:

COOKEVILLE, Tenn. -- Putnam County is looking at the prospect of eliminating primary elections in hopes of saving $60,000.

On Monday night, the county commission voted 14 to 9 to ask the county parties to forgo primary elections and select candidates through private caucuses.

Primary elections are historically low-turnout, but nonetheless canceling an election for fiscal reasons sends off alarm bells with me. You tea party folks yammering about your loss of freedoms might want to consider what it means to cancel an election because the county doesn’t have the funds to stage it.

Who needs safe school buses, elections, or health care for the elderly, right? Those things are not as important as making sure large corporations don't pay any taxes and the wealthy pay even fewer.

Simon Johnson:

Competition between banks is good – on this ["immaculate regulation" advocate Charles] Calomiris and I agree. We differ with regard to whether allowing large quasi-monopoly banks to dominate the landscape (e.g., Goldman Sachs and JP Morgan Chase today) is helpful to competition in any sense.

We should also throw into the mix three additional considerations.