Meet the New Congress

Heard a really remarkable interview on MPR today. It was with a Congressman from Florida who chairs a transportation committee, John Mica. In the short interview, Mica, who came across as a reasonable and likable guy, really did a remarkable job of downplaying the entire tea party movement.

First, he backpedaled on earmarks, saying that earmarks were necessary to keep the President from just doing whatever he wanted. Fair enough, but pretty different from what the R's were saying the last couple of months.

Then he said about the health care reform repeal, and I'm trying to not paraphrase too much: A) I'm going to vote for it, B) it's not going to pass (presumably he meant it would fail in the Senate,) and C) I don't really want to repeal health care reform anyhow.

He then went on to throw up a smokescreen of false and misleading points about the new health care law, for instance saying that it's wrong to mandate health insurance coverage when people can't afford it (the reform law specifically addresses that issue to make it affordable through subsidies), and saying it's too expensive (when in fact repealing the health care reform law will add $100 billion to the deficit).

By this point, I've come to expect R's to peddle in misinformation, tho it was disappointing to hear it from a guy who seemed reasonable otherwise. But it was really incredible to hear the mental gymnastics required to say, "I'm going to vote for something I don't agree with because I know it will eventually fail."

I may disagree with him on the larger points, but on this, I hope he's not wrong.

AaaaOOOOOOOOGA! The horn blows for Childress.

It’s been easy to place blame on Brad Childress for the astonishing collapse of the Minnesota Vikings this season. Blame could also be shared by Brett Favre, an inconsistent-at best receiving corpse (hey, let’s just leave that typo in there, it fits), rapidly aging lines on both sides of the ball, and a secondary that has some very questionable pieces.

But the real culprit for the Vikings mess is owner Zygi Wilf. And he’d better figure out quickly that he needs to change the basic organizational structure of the team, or it’s likely to be in exactly the same place in a year or two. Or sooner.

Wilf did not have a lot of football know-how when he bought the team. And it has showed. With no strong general manager, Wilf pushed most of the power and decision-making to the head coach, and that has been a disaster.

Childress may actually be a pretty good coach on some levels. After all, he had two pretty good seasons with the Vikings and was one-increadibly-boneheaded-I-can’t-believe-Favre-did-that-again-does-he-have-a-death-wish interception away from taking them to the Superbowl.

But then the wheels came off this season. And why? One word: personnel. Childress went for the short-term glory of bringing in big stars like Allen, Favre, and infamously, Moss, rather than cultivating a deep bench of players who could step in if the starters faltered. And falter they have. This team peaked big time last year and clearly Childress had nowhere to go when players like Williams and Rice either got hurt or lost a step.

And just as a side note: what message does it send to the rest of your team when you go for a star player and tacitly tell the world he doesn’t have to play by the same rules as everyone else? Doesn’t have to come to training camp? Gets special treatment. Yeah, Farve’s a legend. But the psychology of this team was dysfunctional from the day Childress played chauffeur to Favre at the beginning of last season. It was festering all along, and the dam burst this year with Moss.

A strong general manager who could avoid the impulsive, go-for-broke decision-making that doomed Childress’ tenure is needed badly by the Vikings. I don’t know if Wilf will be able to figure out how to right this ship. But firing Childress is just the first, and easiest, step.

Waiting for the Great Leap Backwards

In thinking about tomorrow’s election, I was reminded of something someone said after George Bush’s popularity began to plummet early in his second term. “No matter who’s elected, they’re going to have such a mess to clean up they may not want the job,” the statement went.

That seems especially appropriate now. We had two elections that brought Dems to power, and people expected improvements, but the problems that had been building up over eight years—or longer—have turned out to be very tough to fix.

So here we are, poised to punish the Democrats for not fixing the mess Republicans made quickly enough, and putting Republicans back in power to mess things up a little more—or, more likely, to ensure more gridlock on the really tough problems.

Good job, American Democracy.

Hey, it’s not the end of the world. We’ve survived worse than handing power to a bunch of crazy tea-partiers who don’t know what the heck they’re talking about.

I think.

Minnesota, the nice tea party state

I was talking to Al Franken the other day—OK, it was a few months ago and it was the one and only time I have spoken to the man—and he said something like, “you know, we have tea party types here, but they’re nice tea party types.”

And it does seem that the extremes of tea partiers are a little less extreme here. I mean, we do have the tea party queen in Michele Bachmann, but other than her the crazy gets dialed down quite a bit in Minnesota.

Bachmann is cruising against Taryl Clark in the 6^th district. Clark may make the race a bit tighter than former opponents, but I agree with those who say that in the year of the Republican Wave, Bachmann is not going down. Bad timing for Clark.

Tim Walz seems pretty secure down in the 1^st district, probably because he’s so likable and down to earth that the R’s can’t make much traction in arguing he’s part of the problem. The problem is supposed to be out-of-touch Washington insiders who don’t listen to their constituents, and Walz just doesn’t allow himself to get tagged with that. He is dogged in his attempts to stay tuned in with his voters, even if he doesn’t always take the most popular stance.

It is a sign of the times that even Jim Oberstar up in the 8^th district is seeing a challenge, but that seems to be the case with his race against Chip Cravaack. Some internal polls released by the Cravaack camp suggest he was within a point or two of Oberstar. But like Derek Wallbank, I really doubt the underdog can pull this off. I was just up on the North Shore and there can be no doubt that Oberstar brings home the bacon to his district. I have never seen nicer roads than the county highways north of Duluth. I mean, they were amazing. I felt like I was in a car commercial. Of course, some might say that proves that Oberstar is a pork-addled Washington insider, but somehow I doubt he’s going to lose tomorrow. If I’m wrong, it is REALLY going to be a long night for Dems.

Those are the closest congressional races. And except maybe for Walz, I would expect that they end up not being that close.

The governor’s race looks like it will be tight to the end. I have to give credit to Mark Dayton. Despite being far from the smoothest public speaker, despite his rather risky stance on raising taxes on high earners, despite his less-than-stellar track record in office, he has managed to run an efficient and effective campaign. He hasn’t made a major mistake, as Hatch did four years ago.

Tom Emmer also deserves credit. Early in the race, it looked like he would implode and lose his support to the more moderate Independence Party candidate, Tom Horner. But Emmer shored up his base, stopped shooting himself in the foot, and turned on his considerable charm and enthusiasm to make a close race of it. As others have pointed out, when it comes to Minnesota, if the R’s and D’s both turn out the base, the D’s just have the numbers, so they win. That will probably happen tomorrow.

Horner has to be disappointed that he didn’t make more headway with voters. I think a lot of political observers thought that policy-wise, he was the most articulate and made the most sense. You could say he “won” a lot of the 472 debates (a mild exaggeration of the numbers there)

From my viewpoint as someone observing the health care industry, it surprised me that Horner pulled in the endorsement of both the Minnesota Medical Association (MMA) and the Minnesota Hospital Association. When that happened, I thought he might actually have a chance to pull in a lot of more moderate voters. But he’s never come close to cracking 20 percent and making this a real 3-way race.

What that tells us, I think, is that even in Minnesota, where Jesse Ventura once shocked the world, people are comfortable with our two-party system. For all the talk about tea parties and independent voters, we’re still a red and blue electorate.

Wisconsin Swings Back

A state that had been trending blue is going to reverse itself tomorrow, if the polls are correct. Russ Feingold, a great independent/progressive voice and one of the most principled people in the Senate, will lose to ultra-pro-business newcomer Ron Johnson. Anti-government crusader Scott Walker will trounce Milwaukee mayor Tom Barrett.

Progressives will mourn the loss of Feingold, but Scott Walker’s win is a real nightmare for the people of Wisconsin. He is a true believer in downsizing government to the point where it basically ceases to function, as he has proven in his role as county executive for Milwaukee County. Expect Wisconsin’s next governor to be extremely partisan in fighting against health care reform, nixing mass transit projects, slashing education, etc. As George Bush so ably did, Walker believes government can do no good and is dead set on proving it.

Johnson on the other hand will have little power and less know-how, at least to start. He won’t help with much but other than being an R vote, probably can’t do too much harm.

*cough* dusty in here... somebody open a window...

So yeah, I'm firing up the blog now that we're a month away from another big election.

Hopefully it will cut down on me posting an annoying amount of political stuff on FB. I hope so anyhow. If I could keep it to posting, say, 3 or 4 things a day there, that would be good...

My first shockingly radical political thought has to do with health care reform, of course. I'm on this mailing list of a bunch of cranky doctors, most of whom are strongly opposed to the health care reform law. Oh, there are a few hippies who think it's a good thing to address the issue of millions of uninsured, but many of these docs are just aghast that the government is going to take some steps that might affect their income--ooops, sorry, interfere with the doctor/patient relationship.

What really strikes me is not that a bunch of older physicians who are set in their ways and are quite comfortable with the system as it is are opposing change. What strikes me is that after spending 30-plus years complaining about health insurers and how they are the source of all evil in the world, many of these docs now have turned around and are defending health insurance companies against the ravages of government-controlled health reforms. It really is a head-spinning turn of events.

Mothballs

Yeah, it's become pretty obvious that I can't keep up with the ole' blog. My last post was in March??? Ouch.

Facebook is just a much more immediate and inclusive medium. Even though in theory anyone in the whole wide web can come here to ML, that's not the way it works out. With FB, you know you've got an audience, though you give up some things, such as privacy to some extent.

On the other hand, lots of folks are not interested in political debate on FB, and I probably am quite annoying to them. But some are. It's just not practical to try to drag them to this blog and expect them to make it a destination, especially when I can't even do that myself on a regular basis.

And the truth is, Ezra Klein and Josh Marshall say everything I would say, and more, much better than I could say it. So linking to them is simply more efficient.

I'm not closing the account. There's an election this fall (and unless Obama triggers the Rapture, more to come) and it will probably make sense to fire this site up then, when I have more to write about.

Until then, see you on FB!

PS: I'm also still blogging on MySpace, but that's pretty much just about music stuff.

Good night, everybody, everywhere. Goodnight...

“This is what change looks like”

A few months into the Obama presidency, a liberal friend tried to pin me down on my position on health care reform. Now, I’m not really hard to pin down—I support reform. I’ve been a pretty loud advocate for it. But he wanted to know my opinion on the public option, a measure he saw as essential. I was reluctant to take a militant position on the public option, not because I didn’t see it as a good idea (I do) but because I didn’t see it as the silver bullet of health care reform.

About the same time, I was arguing with conservative friend who thought that the Democrats were just trying to create a huge entitlement program for all the unemployed people, in effect (he argued) “buying” their vote with the currency of health care. I replied that health care reform isn’t about free goodies: it’s about making all of us more economically secure, regardless of whether we’re employed or not.

With such a contentious, divisive issue, I found myself again and again drawing on my experience with people who are actually in the health care industry. I’ve been watching and listening for more than ten years as industry people talked about reform. What I hear over and over again is that our health care system is broken, unsustainable, heading for disaster. I hear words like “catastrophe” and “crisis.”

Year after year, I’ve heard people talk about the failures of our system. And it was more than talk. The doctors and health system people—as well as many the insurance side, knew all too well how real lives were being damaged by the lack of access to health care. They saw the price people paid for being uninsured. We heard those stories over and over again. But when the speech or the conference was over, everyone would go their way, until the next conference or speech.

There just wasn’t enough consensus on how to fix the problem. And I frankly questioned how we ever would find consensus, given the entrenched positions of people, not only politicially, but from their different places as stakeholders in the industry.

One of the really remarkable things about this health reform campaign of the last year was how Obama was able to get industry players on board. The American Medical Association. The drug companies. AARP (representing the Medicare constituency). Even the health plans, though generally opposed, were muted in their criticism because they simply could not make the argument change was not needed.

You can certainly turn that around and say that Obama has sold out to the special interests. But the bottom line is that it would be impossible to bring about reform without the industry being part of the pro-reform team. Unless, of course, it was done with as a kind of top-heavy, big government takeover of health care—outlawing private insurance and replacing it with a government system, for example. In this political climate, who thinks that would have worked?

There were many times during this process I thought health care reform was dead. But time proved me wrong. Just as it has proven Obama right. This is what change looks like. It’s a long, hard, contentious process, and even when you get to the “end” there’s much more to do.

People voted for change in 2008. They voted for health care reform—it was a major campaign issue. They voted for a new approach to our economy and our politics. It’s been a long, hard, contentious battle for those things so far. But we have a president who is delivering on his promises.

And we have passed health care reform in the United States.

“Help Me, ObiWan-AG, You’re My Only Hope”

I’d say the chances of a court challenge overturning health care reform is just slightly less likely than Leia and friends blowing up the Death Star. And remember, folks, that was Hollywood.

There’s been a lot of talk about how the individual mandate (originally a Republican idea) is unconstitutional. Blah blah, Commerce Clause, 10th Amendment, woof woof. If people don’t choose to buy insurance, they’re not part of commerce, therefore, they can’t be forced to be part of the system. This ignores the fact that a) everybody gets sick sometime and 2) they will then access the system, which has real costs, presto, commerce!

This Pioneer Press article is one of many to throw cold water on that idea. Sure, the Supreme Court has been very activist lately, often throwing out decades of precedent to pursue their conservative vision of America, but it seems unlikely they would legislate this openly from the bench. And if they did find the individual mandate unconstitutional, there’s a quick fix: change it so it’s not a mandate—
just make it really hard to refuse.

Here’s part of the PriPress article:

“[The Supreme Court ruled] that staying out of the marijuana market rather than participating in it does affect commerce (even if the market is illegal). Conservative Justice Clarence Thomas and then-Chief Justice William Rehnquist sided with Raich, but the court's liberal wing prevailed, even winning over conservative Justice Antonin Scalia.

‘Raich seemed to stem the Rehnquist court's rollback of Congress' Commerce Clause power. And Justice Scalia went along with that, using reasoning that arguably expands Congress' reach,’ said Mehmet Konar-Steenberg, an associate professor at William Mitchell College of the Law. ‘So I don't know how much stomach there is at the Supreme Court right now to try to revive this line of cases.’

Furthermore, the links between health care and commerce are clearer, Konar-Steenberg said, pointing out — as others have — that many already purchase insurance and that those who don't have their emergency room bills picked up by everyone else. ‘These don't strike me as attenuated links to interstate commerce,’ Konar-Steenberg said.”

Yes, politicians, have been known to make deals before. You didn’t know that? Really?

I recently heard from a friend who was shocked, shocked to find that Democrats were making deals and twisting arms to pass health care reform. She insisted that this was far worse than anything that had ever gone on before. Well, I don’t know, but I suspect it wasn’t worse than this:

“A 15-minute vote was scheduled, and at the end of 15 minutes, the Democrats had won. The Republican leadership froze the clock for three hours while they desperately whipped defectors. This had never been done before. The closest was a 15-minute extension in 1987 that then-congressman Dick Cheney called “the most arrogant, heavy-handed abuse of power I’ve ever seen in the 10 years that I’ve been here.”

Tom DeLay bribed Rep. Nick Smith to vote for the legislation, using the political future of Smith's son for leverage. DeLay was later reprimanded by the House Ethics Committee.

The leadership told Rep. Jim DeMint that they would cut off funding for his Senate race in South Carolina if he didn't vote for the bill.

The chief actuary of Medicare, Rick Foster, had scored the legislation as costing more than $500 billion. The Bush administration suppressed his report, in a move the Government Accounting Office later judged ‘illegal.’”

(Read the whole thing, it’s pretty amazing.)

RIP Alex Chilton

On a non-political note... I named this blog Mod Lang after the Big Star song, thinking that it would be a place to talk about culture more than politics. Well, it hasn't turned out that way, but just the same, I feel I should note the passing of Alex Chilton, who along with Chris Bell founded Big Star.

I was introduced to the music of Alex Chilton and Big Star by Bob Richert, a record store owner and small-label enterpreneur in Bloomington, IN, in the spring of 1981. It was only fitting, then, that I met Alex Chilton in that same small college town a few years later.

I was in town, almost on a whim, to visit a girl. (Of course) I found out that Chilton was playing that weekend and decided to go see him. Since I had been doing some writing for a small music publication in Milwaukee, I decided to push my luck and see if I could get an interview.

Chilton said sure. A couple hours before his show, I met him in the dressing room and we talked about his career and music. I have the article, buried somewhere in my files, but I was a young an clumsy interviewer then, and I'm sure it doesn't say anything that Chilton fans haven't already heard.

He was cynical about the music business. He was proud of his recent work, which at that time consisted of minimalist solo albums (Feudalist Tarts was probably his latest or about to come out at that time.) --almost to the point of being dismissive of his Big Star work. Probably at that time he was sick of being asked about Big Star, which for all its critical acclaim, had left him nearly penniless.

For all his sour feelings for the music business, he was generous with his time and even asked if I wanted a joint. I'm not sure it helped my standing with him that I declined, but I'm sure it was a good idea I stayed clear-headed for the interview.

After the interview, Chilton played to maybe two dozen people in a no-frills club called Second Story. He played solo and included many choices that I found curious at the time, including old R and B standards and the Italian pop classic Volare (which was a staple for him for many years). Big Star songs were few and far between. But Chilton was following his muse, which he had doggedly done since leaving the Box Tops, and he clearly wasn't interested in reliving his pop-rock legacy.

At the end of the interview, I asked something along the lines of, since he was a hero to many budding songwriters, did he have any advice for them? He looked me in the eye. "Yeah, " he said. "Go to law school."

He was funny, he was cynical, he was dark, and he was light. He was, as he once wrote, "a true heart." He stayed true to his music and himself, even when that wasn't the smartest or easiest call. But he didn't let go of that vision. He held on, and so many times, his music has helped me to do the same.

Thanks for the interview, Alex. And everything.

From now on, let's say we call those "Jim DeMint boots"

Called it.

A couple of days ago, I thought of posting a Facebook status line saying, "COUNTDOWN TO SOCIALISM!!!"

Just as a snarky jab at my conservative friends who have been hyperventilating about this health care reform thing.

Then I thought, nah, let's be a little more gracious than that.

But lo and behold, someone's doing it for reals. "GOVERNMENT HEALTH CARE TAKEOVER IN: 12:23:43" reads prominent banner ads on the Washington Post website. "You Can Stop Obamacare: Act Now!" the ad continues. And "Paid for by the Republican Congressional Committee."

Keeping up the bullshit 'til the bitter end.

A brief history of health care reform in the US

Democrats: "We need health care reform. Let's do Plan A."
Republicans: "We don't like Plan A. We want Plan B."
(TEN YEAR PAUSE)
Democrats: "OK, we'll do Plan B."
Republicans: "No, we want Plan C."
(TEN YEAR PAUSE)
Democrats: "OK, Plan C, then."
Republicans: "Plan C is socialism. We want Plan D."
Democrats: "We're starting to think you're not serious about this."

livecaresummitbloghealth10 : hey, let's not let those uninsured people dominate this discussion...

Dropped back in on the summit and found another Democratic nonwhite guy. Rep. Xavier Becerra squabbled a bit with Paul Ryan, and makes the point that if you throw out CBO numbers, we can’t discuss this.
(CBO tells us the Dems health care reform bills reduce the deficit by 100 billion in the first ten years. Ryan may disagree with those numbers, but they’re the best we have, and the best we’re going to have.)

Boehner is up:
Thank you for having us. A useful conversation. Don’t disagree with premise of meeting.
Our job is to listen. I’ve heard an awful lot. What I’ve heard more than anything ist hat the American people want us to scrap this bill.
Let’s talk about why
Fiscal condition. We’re going broke. This new entitlement program will bankrupt our country. I think this is a dangerous experiment. We may have problems, but we have the best health care system in the world. A government takeover of health care, and I believe that’s what that is, is risky.
The last thing we need to do is raise taxes. $500 billion in cuts to Medicare. It’s going to drive up unemployment. Employers will dump employees into the exchange. Federal government is going to design every single health care plan in America within five years. For thirty years we've had a federal law that says we’re not going to have federal taxpayer funding for abortions. This bill allows for taxpayer funding for abortions
So let’s scrap the bill. Let’s start with a clean sheet of paper we can agree on.
I’ve been patient, I’ve listened. Why can’t we come to an agreement on selling across state lines, malpractice, etc.

(A thoroughly dishonest and distasteful performance.)

Obama: every so often we go back to the standard talking points. And that doesn’t drive us to agreement. There’s so many things you said, that people here disagree with and based on my analysis, just aren’t true. We were trying to focus on the deficit. The CBO says this will reduce the deficit. Paul may disagree. I’ll get back to you on some of these.


Rep. Jim Cooper. Medical expenses driving us off the cliff. Tough talk is not good enough, we need to take tough votes.


Dick Durbin
Orin Hatch asked CBO about tort reform. It saves $54 billion over ten years.
5.4 billion a year is a lot of money except when compared to the 2 trillion we spend each year on health care.
And if we do have tort reform, more people will die. Thousands more.
There are other ways to reduce medical errors and lawsuits that should not be filed.
The number of paid malpractice claims have been cut in half in the last ten years.
Money paid has been going down, cut in half in last ten years.
This is an important issue but to make it the overriding issue is [wrong]
The best health care system in the world for the wealthy. We should give everyone the same plan congress has. If you think it’s a socialist plot for goodness sake drop out of the federal health benefit plan.

(One of the more powerful, and shortest, speeches today.)

Obama: looking at access now. Republican plan would cover an additional 3 million, Dem plan would cover an additional 30 million.
This may be most contentious part: it does cost money. But let’s not pretend that we’re going to cover another $30 million for free. If we think its important as a society to not leave people out then we’re going to have to figure out a way to pay for it.

John Barrasso
This is about all Americans, not just those who don’t have insurance (???).
He says *everyone* believes that passing the bill will increase costs. Will make care worse. Will hurt seniors.
They all believe that because you keep lying to them.
Gotta take another break.

sumbloghealthliveit9care

Ok, gotta take a break for awhile. Hopefully will come back late in the day with some kind of summary.

For the record, a nonmale Republican has been sighted.

livehealtblogcaresummit8

McCain

Wants to talk about process. Taking a pretty critical tone; talking about lack of transparency, “unsavory deal making,” asking rhetorical questions, just being his usual grumpy old man self.

Boy, he’s really making us regret electing Obama.

Obama tries to cut in, McCain steamrolls on, says Americans want us to go back to the beginning. He really reminds me of the debates. I don’t know who this is good for. He’s certainly throwing mud at Obama. Will it stick?

Obama: let’s get back to the issues.

Is Saturday Night Live on this weekend? ‘Cause if it’s a new episode the opening skit should be awesome.

Nancy Sibelius is talking to a roomful of people who probably are counting the minutes to lunch. OK, just an observation. So far this has been going on all morning. Lots of people have been talking. A total of two, I believe, were female. A total of one was not white. The nonmale nonwhite contingent were all Democrats. Just making an observation about how inclusive and diverse our government is these days.

Eric Cantor has a huge stack of paper in front of him, comes about up to his collar. Obama asks about it. I guess Eric wants to be able to look stuff up if he needs to.

“There is a reason why we all voted no.” (Yep, it’s called November).

He says it’s ‘cause the sec. of HHS will define benefits. What these guys are arguing is again, that government can’t work. I guess that’s an argument. Sure isn’t a constructive one, though.

Taking on oversight of insurance premium increases. Government regulation will force premiums to go up, says EC.

Obama ripping apart his talking points. Making the point that regulations are necessary to protect consumers. Explaining the concept of risk pools. Man, it’s sad that we’re at this point.

“We just can’t afford this.” Cantor.

We could afford two wars, massive tax cuts, and the Medicare drug benefit you voted for. Right.

Cantor is dogged, I’ll give him that.

Oh, hey another nonmale. Hello, Rep. Slaughter. Hey, she's pretty good. But she used the phrase "eating my lunch" and I could hear people shifting in their seats.

Livehealthcaresummitblog7

Best new catchphrase (and movie pitch) from summit:

Undercover Patient.


Schumer notes that we can’t health care costs without cutting waste in Medicare, hits R’s for saying you can’t cut Medicare.

Sen John Kyl
We do not agree with the question on who should be in charge.
Do you trust your doc or do you trust Washington.

Oh, he’s going back to the premiums. Quotes a letter from CBO; premiums will go up because it’s a richer benefit, because the government would mandate it. Getting into acturarial tables. Govt will mandate that insurance will cover more things, so premiums will go up. Taxes.

Kyl has a big pile of papers in front of him, and danged if I don’t take him more seriously. Best use of props.

Taxes, fees, will increase the cost to the consumer. That’s why R’s would rather start by not having to raise a lot of money to pay for bill, instead take it piece by piece.

(my question: how many years til we get reform that addresses the real problems that way? 5? 10? 25?)

Obama responds:
Premium argument. If I’m self-employed, can’t get coverage. High deductible plan: it’s not health insurance, it’s house insurance. (good phrase) What CBO is saying: if I have an opportunity to buy good insurance, costs more but is real insurance. So yes I’m paying more because instead of buying an apple I’m getting an orange.

The federal benefit has a minimum benefit that all in congress enjoy. We’re saying we’re going to do the same thing for others that we do for ourselves. Saying there’s a baseline of coverage is not some radical idea. A lot of states do it.

I just want to point out the issue of gvot regulation is very different than the way this has been framed. This is not a government takeover of insurance. (He’s hammering home that point, I guess it needs to be said)

James Clyborn is talking up community health centers as a way to address cost and access issues. No matter what we do, there should be sig. expansion of those centers.

HCSummitLiveBlog6

Coburn called for undercover patients. I love that song.
“Undercover patient, midnight fantasy…”

After Coburn, Obama points out again, that many of the cost containment ideas and prevention ideas are already in the bill. This is going to be common theme of today: you guys say you want xyz reforms, hey, they’re already in the bill.

Here’s Steny Hoyer, telling Coburn the bill does exactly what he suggests in working on Fraud in Medicare & Medicaid (hereafter known as M&M)

Steny seems more focused and articulate than Reid/Pelosi. Not necessarily more exciting, but I don’t find myself saying, wait, what? …as much.

Obama: what are your objections to health insurance exchanges? I know some of you have agreed to this concept in the past. (ooo, nice passive aggressive move.)

JOHN KLINE, from MINNESOTA!!

Kline: we’re looking at thousands of pages of legisatlion, better to go step by step. We have proposed that small biz be able to band together.

I love that tie. I mean it, it’s outstanding.

Let small biz band together to get the same advantages that bigger co’s have. Obama, nodding. Kline: we think that’s a better idea than exchanges.

Obama asked Max Baucaus to respond.

Baucus: this is what strikes me. We all know what the problems are. We are actually quite close. The gaps are not that great.
Going back to Lamar. We’ve got most of what R’s want. Across state lines. Tort reform (HHS working on) . Baucus seems nervous and a little tongue tied.
HSAs work pretty well for middle and high income people.
Small business: we’re not that far apart. Association health plans (Kline’s thing) That’s fine, what we provide is the SHIP Act. Bipartisan, allows small business participation in exchanges. Major provisions on fraud and waste in the bill. We basically agree. Looks like he's ready to start hugging people.

(I sense a real advantage here for the Dems. They keep hammering home that they have made reasonable attempts to address the R concerns. They show how the bill incorporates R ideas. They get a chance to explain how the bill works and what it does. The R’s can’t come back with the outright falsehoods, because Obama has made it clear he won’t let them pull that stuff. Obviously, I’m pro-reform so my take on this may reflect that. But this seems effective to me.)

McConnell yields to Boehner, Boehner yields to … who is that? Camp? Rep. Dave Camp. He says if you care about costs, why are you spending a trillion dollars? (because it reduces the deficit?) He says someone (medicare?) says the plan does not bend the cost curve the right way. He wants malpractice reform. Quotes CBO that says med malpractice reform would reduce deficit.

Remember he quotes CBO.

Lots of details with this guy, he’s definitely a policy guy, seems more prepared than some of these guys. Talks about an unelected board to make Medicare cuts (death panels!)

Obama cuts him off: doesn’t want to get off on tangents, then lets him finish.

Obama and Camp getting into premium increases. When all this is structured around a government centered exchange: that kind of approach raises cost. Mandates.

Rob somebody. Robert Andrews.
He says difference between association and exchanges is semantic mostly, one substantive difference. Different consumer protections in diff. states. Shouldn’t be 51 different sets of rules, one reasonable federal standard.

Republican guy just said he doesn’t hear people complaining about their health insurance companies. “We do” says Andrews.
“We don’t agree with the idea that the insurance company gets to make (medical decisions.)

McConnell has been keeping a stopwatch. Sheesh.

Paul Ryan from Wisconsin. Washington shouldn’t mandate things. Let the industries set up their associations for their members. We want to decentralize the system, give more power to small businesses.

Andrews: asks Ryan about setting consumer protections.

Should people in Washington decide for everyone?

Obama says its an important point.

Obama: Focus in on this philosophical debate. Legitimate points. When I was young I had to buy auto insurance. It was a joke. Health insurance is different. We should set up minimum standards in the exchange. It is true you can always get cheaper insurance if it has high deductibles or doesn’t cover things. The principle of pooling is at the center of the bills. A lot of talk about government takeover. That’s not the issue. The issue is how much should govt set a baseline?

When we start talking about how much government involvement – it’s not that it’s a takeover, it is that govt is setting up regulation, baseline requirements.

MST3K5

Obama doesn’t respond much to R criticism, but notes that some areas of agreement,
Says let’s not dwell on process and stick to substance

Everyboy agrees on cost

Talking about costs, costs to businesses,
Talks about exchanges –not a Democratic idea but a Republican one! (dig it!)

CBO cost estimates: plan would lower costs for individual markets, calling Lamar out on this, Lamar cuts in--CBO says premiums will rise Obama-no no no
We have to get our facts straight, what you said, Lamar, was not factually accurate
Costs for families would go down 14 to 20 percent
Because they now have a better deal, they may chose to buy better coverage, which might be more expenseive

(So we have our first tussle. Decision, Obama.)

Obama still going over cost containment in the proposals.
Additional ideas that R’s have suggested, that we have included
Buying across state lines: that’s in the proposal
What we’ve tried to do is take every single cost containment idea and put it in bill

What ideas you have that you don’t think are in the bill to contain costs?

10:00

Not letting LA cut back in.

We’ve adopted a lot of your ideas

LA: I punt on this other stuff.

I think your wrong on increasing premiums, I’ll put my facts down and send them to you.

Obama: I’d like to get this issue on premiums increases settled before the day’s out.
(Yes!)

McConnell: Can I get a Pepsi?
(he did not say that)

McConnell: The American people hate this bill. Hate reconciliation.
Calling Dr. Tom Coburn. Stat!

Coburn (whoa, lookat that hair!)

We’re performing bad medicine.
Govt health care doesn’t work

Cost is the problem.
We could solve this problem if we just address costs! There are lots of ways to fix this!
Tort reform! Change the school lunch program!
(I smell a Nobel prize)