Dems’ pre-existing condition: making bad compromises

Dems show pre-existing condition: compulsion for disastrous concessions

February 2
1:40 am

The Democratic healthcare reform effort has been gasping for air, as Art Levine suggested in his recent post.

But healthcare reform certainly won’t be resuscitated if Democratic
leaders persist on drawing the wrong "lessons" from the victory of GOP Sen. Scott Brown in Massachusetts.

In line with their reflexive response of moving to the Right when presented with any problem, the Dems’ leaders in Congress are preparing to further water down an already constricted and flawed bill that has been losing supporters precisely because of its weakness, as shown by Brown’s win.
Thus, the Dems are considering a plan to shrink benefits their health plan even further, notably in the area of pre-existing conditions. At the same time, the Democratic National Committee has shelled out nearly $500,000 to Sen. Ben Nelson–a remarkably selfish and obstinate foe of reform–so that he can run TV ads disparaging the Medicare-style "public option" as an alternative to profit-driven healthcare.

The Massachusetts Senate race was a disturbing warning shot that the tone-deaf administration and congressional leadership seems to have misinterpreted as a call for a more "bi-partisan" approach, rather than an urgent signal to aggressively take sides with suffering American families hammered by job loss, wage cuts, home foreclosures, and tight
credit.  As Research 2000 polling revealed,

A majority of Obama voters who switched to Brown said that "Democratic policies were doing more to help Wall Street than Main Street."

President Obama was masterful and overwhelming in his meeting with the Republican House caucus on Friday, slicing and dicing them with ease. But Obama’s  mission was entirely pointless if he was attempting to persuade the Republicans to start working cooperatively with him.

After a year of unremitting opposition and venomous attacks, why would the Republicans start giving him legislative victories of any kind t in this election year?

 Additionally, there is clear and complellingevidence from the Massachusetts race that alienated voters felt that the Democratic health plan did not go far enough":

Among those Brown voters [who had voted for Obama], 23 percent thought it went "too far" — but 36 percent thought it didn’t go far enough and 41 percent said they weren’t sure why they opposed it. Among voters who stayed home and opposed health care, a full 53 percent said they opposed the Senate bill because it didn’t go far enough; 39 percent weren’t sure and only eight percent thought it went too far.



At their  core, the Democrats’ health plans (both Senate and House) were built around abargain wherethe insurers would give up discrimination against people with pre-existing conditions in exchange for the government handing them some 30 million taxpayer -subsidized customers.On this point, many liberals and progressive mistakenly equated the mandate–to buy a badly flawed and generally unaffordable product–with  universality. As Norman Solomon has pointed out,

The mandate places legal, financial and ideological burdens on the individual for healthcare. In the process, at best, many low-income people would only have access to inferior coverage with plenty of holes.

The insurers were also supposed to eliminate annual and lifetime limits.
However, the provision prohibiting annual limits mysteriously disappeared from the Senate version. So, contrary to Democratic claims, there is now both an annual limit and consequently,  a lifetime cap  on benefits.

In place of the House version’s funding schmed based on taxing families earning $1 million or more, Baucus and Co. inserted a regressive and much-hated tax on benefits that has severely alienated many unionists.

The Senate, with Finance Chair Max Baucus at the helm–his pockets overflowing with insurer cash— and ex-insurance lobbyist Liz Fowler at his side, also gave up the notion of removing the insurance industry’s federal
anti-trust exemption.

Earlier, the Senate had dropped the popular Medicare-style  public option  (which the Lewin Group consultants in 2008 projected that some 130 million Americans would seek to join), cut out government negotiations on drug prices, and maintained the ban on drug importation from Canada.

The last was a move which badly undercut progressive South Dakota Sen. Byron Dorgan and likely shaped his decision not to seek reelection this year. Notes Robert Kuttner, author of Obama’s Challenge,

[The concession banning Canadian drug imports] has already brought down Senator Byron Dorgan of North Dakota, a fighter for health care and other reforms far more progressive than President Obama’s."


More recently,  there have been some signs that the White House and Democratic leaders are ready to further reduce public benefits so that some deal, any deal.  can be reached with the insurers.  The insurers will surely feel that they can drive a hard bargain with the White House, keenly aware that the Administration is desperate to come away with something to show for all its exertions.

Recently, the White House has been floating trial balloons about limiting the coverage of the anti-discrimination provision on pre-existing conditions to those 19 years old and younger. As the New York Times reported:


The consensus measure would be less ambitious than the bills approved last year. It would extend insurance coverage to perhaps 12 million to 15 million people — and provide political cover to Democrats, who said they could not simply drop the issue after spending so much time and effort on it. The pared-back approach would cover fewer than half of those who, according to the  Congressional Budget Office, would gain coverage under the House and Senate bills.

But it would not put the government on the hook for what critics say is a new entitlement, a change that would appeal to some Republicans….
.Congressional aides and health policy experts [stated]
"Insurers could not deny coverage to children under the age of 19 on account of pre-existing medical conditions.."

Moreover, Democratic advisor David Plouffe, in a recent Washington Post column, very tellingly described the sharly-limied benefits of the Democrats’ latest plan in an entirely new way:

Parents won’t have to worry their children will be denied coverage just because they have a preexisting condition.

As John Aravosis, writing on Americablog noted angrily, "Their children? The original promise – even the bad Senate bill – protects everyone, of any age, from being denied coverage because of pre-existing conditions. Now it’s just children?" Plouffe’s comment was quite carefully crafted, "as CBS News reported that the pre-existing conditions promise was now looking unlikely."

Throughout the healthcare reform fight, Nebraska Sen. Ben Nelson has consistently distinguished himself as someone whose name will go down in infamy as a shameless tool of the insurance and drug industries. He helped defeat the public option, one of the few features of the reform package that the public could identify as a positive change. As the price for his vote for passage of the healthcare reform plan in the Senate, he demanded special treatment for his own state on Medicaid. This left the healthcare bill further tainted  with traditional slimy, vote-buying politics.

(Just to round out  his profile as a multi-issue enemy of working people,  Nelson has  declared his opposition to the Employee Free Choice Act which would restrict management’s ability to drag out union representation elections and fire union supporters )

But the election of Scott Brown, while making passage of both healthcare reform and labor law reform more difficult, actually renders the know-towing to Nelson irrelevant. If the Democrats are going to get anything done, it’s pointless to shoot for a now-impossible 60 votes and they have alternative but to pass legislation with for 50 votes via the
reconciliation procedure. So there’s no longer any need to kiss up to the likes of Nelson, Joe Lieberman, or Mary Landrieu.

So you’d expect that the Democratic leadership would make Nelson pay for endangering the legislation on which President Obama and the Democrats have placed virtually all their chips. But t hasn’t quite worked out that way, as Sam Stein reports::

On Monday, Joe Sudbury of Americablog reported that the DNC had forked over $459,760.00 to the Nebraska Democratic Committee, which, in turn, used that money to sponsor television ads on Nelson’s behalf. Those ads featured the senator explaining his support
for health care legislation in part by noting he had changed the legislation so that insurance coverage would not be "run by the government." It was a clear slight at the public plan.….the real question was why the DNC would pay for ads that maligned government-run insurance at the same time the party was rallying behind that very proposal.

What kind of political geniuses dreamt up a strategy that results in pushing out a Byron Dorgan and propping up a Ben Nelson who turns around and uses DNC money to undermine the element of the plan most popular with
Democratic voters across the country?

After Scott Brown won on Jan. 18, MSNBC commentator Howard Fineman marvelously encapsulated how the Obama administration had gone so wrong on health care almost exactly one year after Obama’s historic inauguration that unleashed such high hopes for genuine reform.

 In choosing to cater to the sleaziest operators in Washington, Fineman  memorably remarked,

Obama took all his winnings and turned them over to Max Baucus.

Fineman could have easily added Ben Nelson,  Joe Lieberman, and others to the list of unworthies on whom Obama invested the hopes and dreams of tens of millions of Americans.

Meanwhile, a bright futue for healthcare reform is increasingly hard to imagine.

Posted by Roger Bybee  ·   share/save


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