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Health care activist Marc Stier has been attending and protesting the Cigna 2010 annual shareholders meeting.  Yesterday he mentioned on Facebook that the health insurance giant had finally confirmed reports that it had been making payments to the Chamber of Commerce — a bitter opponent of health care reform in any meaningful form — even as Cigna professed to be supporting health care reform:

Today, for the first time, CIGNA admitted to making secret payments to the Chamber. They won’t tell even their own stockholders how much money they sent through the Chamber but there is now no question they did so.

He got a snarky comment from one “Bob”* saying, essentially, “I’m shocked, shocked!” As a friend of mine replied:

Well, Bob, it’s kind of a big deal b/c they were making public statements about loving the idea of reform and getting all those uninsured ppl coverage so they could have access to the best health care system in the world. Their collective heart bled for the ppl who suffer or so their mouthpiece, Karen Ignani told us. Secretly funneling millions to kill reform is something that is, in fact, you know, newsworthy.

Millions that might have paid for a few more health-related procedures — but that’s not really the point of all those premiums, is it.

But Bob, *I’m* with you: you and I already know what sanctimonious liars, compulsive cheats, incorrigible frauds, ruthless sociopaths, and bloodsucking intestinal parasites the health insurance companies are — it’s just their nature, it’s not really news.  For my part, I see this report as just a little piece of the puzzle towards an objective, scientific monograph on the species:

Insurans cignaensis has no eyes, vestigial limbs, and a rudimentary but highly specialized brain; like all members of the Insurans genus, it is incapable of survival without a host country.  I. cignaensis’s body has evolved down to a fastening and rasping mouth, a digestive system, and reproductive organs issuing payments to shareholders, PACs, and (recent studies have shown) to symbiont organisms like C. commerce. While certainly unappealing in appearance and life cycle, it is truly a triumph of economic evolution in the Corporazoic Era.

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* Not his real name.
UPDATE, 4/29: Also on Facebook, activist Cate Poe noted additional news from the shareholders meeting: “When asked whether the company would end the practice of dumping customers that file expensive insurance claims, known in industry parlance as “purging,” [CEO] Cordani expressed no interest in doing so. He remarked that “purging” was an “unfortunate” term he would work to change in the industry without addressing the practice itself.” So parasitic behavior I thought was ruled out is still in. I. cignaensis rules!

Last Sunday, conservative and former Bush speechwriter David Frum had the temerity to criticize Republican strategy in the wake of the health care and insurance reforms passed on Sunday.

Last Tuesday, the Wall Street Journal lashed out at him, claiming he “now makes his living as the media’s go-to basher of fellow Republicans, which is a stock Beltway role.”

Last Wednesday, David Frum was forced out of his position at the American Enterprise Institute.  Like others, I had a good time with the news, suggesting a paragraph on the AEI “About Us” page be rewritten as

“The Institute’s community of scholars is committed to expanding liberty, increasing individual opportunity, and strengthening free enterprise. AEI pursues these unchanging ideals through independent thinking, open debate, reasoned argument, and by firing anyone who disagrees with us.”

Scott Horton, in What Frum’s Firing Tells Us About Politics Today, writes that event

…tells us a good deal about AEI and the current dynamics within the Republican camp. In today’s AEI, policy experts aren’t there to do analysis and give advice—they’re there to serve as made-to-order propagandists. Differing views are not wanted.

And that’s true.  But what’s also interesting is how little Frum’s views differed from a Republican Party’s of not so terribly long ago, and how embarrassing they could and should have been for Sunday’s victors, not its vanquished.  For the centerpiece of what Frum wrote was this (emphasis added):

“This time, when we went for all the marbles, we ended with none.  Could a deal have been reached? Who knows? But we do know that the gap between this plan and traditional Republican ideas is not very big.“

And it’s true — even Nancy Pelosi and liberal columnist E. J. Dionne tout the Republican antecedents of the current legislation, identifying its ancestors in Heritage Foundation proposals of the early 1990s, the 1996 Dole campaign, and of course (however much he now hates to admit it) Mitt Romney’s Massachusetts health care bill of 2006.  And they celebrate that.

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Imagine two spotlights illuminating a stage, one with blue light, one with red; there’s some overlap, and a small bluish dog squats there, producing small bluish dog output.  To its right, a tethered Doberman gnaws on a couple of bloody bones, with older ones gnawed clean and abandoned stage left.  When the Doberman’s occasional snarls frighten the little blue dog, it invariably wags its tale and briefly assumes a submissive posture.

Read the rest of this entry »

The playlist above contains three reports from Real News Network:

Progressives debate health care “victory”, 3/25/2010 (transcript)

A story combining news clips from the signing of the bill with interviews of journalist Norman Solomon (Institute for Public Accuracy), Dr. Margaret Flowers, of Physicians for a National Health Program (PNHP), and Dr. Mandy Cohen, Executive Director of Doctors for America.

What happened to health reform? (Part 1), 2/25/2010 (transcript)

Moderator Paul Jay interviews Donna Smith, legislative advocate for National Nurses United and the California Nurses Association, and Mandy Cohen, seeking reactions to the Obama/Democrats/Republican roundtable at Blair House in late February.

What happened to health reform? (Part 2), 2/25/2010 (transcript)

Continues the interview with Donna Smith and and Mandy Cohen.  Smith:” What’s interesting to me is they [the Obama administration - ed.] just didn’t trust how much support there was for real significant change in this country. I think that they—you know, to President Obama’s credit, he wanted to reach out to the other side of the aisle and have this great attitude of bipartisanship. But that’s not what the American people elected when they elected him. They really wanted change, significant change.”

The passage of H.R. 3590 — the Patient Protection and Affordable Care Act — last Sunday, followed by President Obama’s signature on Tuesday, created a set of broad minimum improvements to health care and health care insurance practices in America, by enshrining a prior Senate bill into law.

These may or may not be followed by additional changes in H.R. 4872 — the Health Care and Education Reconciliation Act — now under debate in the Senate, chief among which are provisions delaying and reducing the so-called “Cadillac tax” on high-cost health insurance, a subject rightly of concern to unions protecting coverage for higher levels of work-related injuries and diseases.  Passage of this bill seems likely, since the reconciliation process can’t be filibustered under Senate rules, and thus requires only a simple majority.*  Even if Republicans vote unanimously against the bill (as is also likely), Democrats are likely to command that majority even if several Democratic Senators defect.  [UPDATE: the Senate and House have passed bills fixing minor infractions of reconciliation rules, but without amendments for a public option or anything else; it's done.]

The legislation promises to improve access to health care for millions, and may well rank as a milestone in American social policy — it’s been billed by New York Times business writer David Leonhardt as “the biggest attack on economic inequality since inequality began rising more than three decades ago”, and by conservative writer David Frum as a conservative ‘Waterloo’ that will not be undone.

But the cost to liberal values and goals has also been high.

Public option dead, right to choose denied care
As rehearsed in a post earlier this month, neither House action included a public option — the popular idea of a federally administered health insurance plan to compete with private insurors that was a cost-saver in its own right, and a possible way station to a ’single payer’ health insurance system.  Instead, an individual mandate to purchase health insurance will further fatten the bank accounts of health insurance companies.

Moreover, in the negotiations preceding Sunday’s vote, Rep. Bart Stupak (D) agreed to vote for the bill in exchange for an Obama Executive Order confirming that the executive branch would prevent federal funds from being used to pay for abortions — thus enshrining the so-called Hyde Amendment, passed annually, as a matter of permanent federal executive branch policy.  Together with provisions in H.R. 3590 — inserted by Sen. Ben Nelson (D-NE) to the original Senate bill — researchers are predicting abortion insurance coverage will will not just be eliminated from insurance plans operating under health insurance exchanges, but will also decline overall.  Dana Goldstein (of “The Daily Beast”) writes, “To get the health-care bill passed, a pro-choice president reneged on his pledge to support reproductive rights for rich and poor alike.”

In a second article, Goldstein captured how whipsawed liberal groups could be about the events of the past weeks with the example of Feminist Majority president Eleanor Smeal.  On the one hand, Smeal vowed to go after Stupak by raising money for primary opponent Connie Saltonstall, –while on the other hand she celebrated the passage of a health reform bill won at the expense of reproductive choice: “If you turn down half a loaf, you get nothing,” Smeal said. “Given the realities of the vote count, I am glad that 15 million people will have access to Medicaid, most of whom will be women, and another 17 million will have access to these state insurance exchanges. I think to have nothing would have been horrible.”

Online and on the ground activists score the reforms
But quite aside from what’s not in the bill, there’s also the nagging feeling that what is there is less than meets the eye.  Last Friday, Jane Hamsher of “firedoglake,” who was among the most steadfast supporters of a public option in the run-up to Sunday’s vote, published Fact Sheet: The Truth About the Health Care Bill, an itemized list of “myths” about the pending health care/ health insurance reforms, along with her footnoted rebuttals to each one.

Read the rest of this entry »

Hercule Poirot: If all these people are not implicated in the crime, then why have they all told me, under interrogation, stupid and often unnecessary lies? Why? Why? Why? Why?
Dr. Constantine: Doubtless, Monsieur Poirot, because they did not expect you to be on the train. They had no time to concert their cover story.
Hercule Poirot: I was hoping someone other than myself would say that.
–Murder on the Orient Express, 1974 film version

The “public option” — a health insurance option run by the federal government, for those mandated to obtain new health insurance– seems likely to be dropped from the final health insurance reform legislation apparently on the agenda sometime towards the end of this week.

Last week, Rachel Maddow pointed out the sizeable number of Senators who’ve either co-signed the Bennet letter or otherwise claimed they would support a reconciliation bill with a public option.  Guest Chris Hayes (The Nation) said he thought that support was soft — some Senators were counting on never having to vote for or against a public option.

When Maddow replied that Durbin had just pledged to whip whatever came to the Senate from the House, Hayes continued,

“…except for the fact that what is going to come out of the House is being negotiated between three parties … the House leadership, the Senate leadership, and the White House [...] …it’s become this kind of like murder mystery game of “Clue,” it’s this whodunit, you know, who killed the public option: was it Senator Reid with procedural obfuscation in the Senate chamber, was it Rahm Emanuel with the insurance industry in the Roosevelt Room, everyone is pointing fingers at everyone else and it really is hard to figure out who actually put the knife in.”

And that, of course, is the point.  As in Agatha Christie’s famous mystery, the right way to read the evidence is that they *all* put the knife in, spreading and blurring responsibility for the deed. Read the rest of this entry »

Without it, it’s a giveaway!

Via Real News Network and brought to you by Billionaires for Wealthcare.

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UPDATE, 10/25: Enthusiastic review by Rachel Maddow on MSNBC, hilariously pinch-mouthed writeup by Garance Franke-Ruta in the Washington Post.

I received an e-mail from Representative Chris Van Hollen (D-MD-8) today that updates my knowledge of where he stands in the health care debate.

As Van Hollen might write, I’m pleased to report that he makes repeated and positive mention of the “public option” in his remarks, which naturally center on HR 3200, the “American Affordable Health Choices Act.” From the e-mail:

The American Affordable Health Choices Act fulfills the promise of bringing real change to America through two key provisions: giving Americans the choice of a public health option and providing universal coverage to all Americans. [...]

One of the most significant elements of this bill will be the public health option. A public option is essential for creating choice for consumers and more competition for the insurance companies. The top 10 insurance companies have seen their profits increase 430 percent over the last seven years, yet the majority of Americans’ incomes have stayed flat while their insurance premiums have sky rocketed. A public option will keep insurance companies honest and bring health costs down for the American people.

This may or may not be a surprise to close watchers of the health care reform debate, but Van Hollen’s unequivocal emphasis — at least at this point — on the public option was welcome news to me.  Last year during the election he actually went further, endorsing a “single payer,” Medicare for all reform, but hasn’t opined on that since then as far as I know.

In an September 1 interview with Ezra Klein of the Washington Post, this is how Van Hollen handicapped the prospects for the public option:

Right now, you have Senate moderates saying they can’t pass a bill with a public plan and House liberals saying they won’t pass a bill without one. Is health-care reform between a rock and a hard place?

We need to let it play out more. In the House there’s a consensus in support of the public option, and people coming back from their districts continue to support a public option. Then we’ll have to see what the Senate does and where we go from there. As we come back, the White House will have to play a bigger role in this debate.

I wonder how he rates Obama on that score now; that’s somewhat less than a pledge to fight for a public option no matter what.  But given his continued support for a public option — a stance that is presumably in step with other House Democrat leaders — it’s important to support Baucus bill amendments like Jay Rockefeller’s that add the public option to the Senate bill.

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EDIT, 9/25: “Representative,” “(D-MD-8),” and link to the congressional web site added.

Click to  pledge that if incumbents vote against
both a “public option” and “single payer,” you’ll
work against them in 2010.  More here.

There’s a lot to unpack in Aziz Poonawalla’s post “Baucus bill follies: the public option is anti-progressive.” In it, he levels a blast at people like me who are insisting that at least a public option be part of health care reform, writing that the “public option” does “exactly zero” towards bringing affordable coverage to all Americans.  He bases this in part on the contention that

“…the public option would only be available to a small fraction of citizens who are either ineligible or unable to afford private insurance.…”

This isn’t entirely clearly written, so while Aziz and others may not disagree, let’s make sure: the public option* will eventually be available to anyone who can enroll for the “Health Insurance Exchange” risk pooling market, i.e., anyone who…

• is not a full time employee with a qualified employer health benefits plan (QHBP), i.e., affordable and meeting benefits and consumer protections standards, and
• is not “enrolled in another qualified health benefits plan or other acceptable coverage,” with”acceptable coverage” including things like Medicare, Medicaid, Department of Defense “TRICARE,” and approved state health benefits risk pools like (perhaps) the Massachusetts “Connector.”

Redrafting, then, “the public option will eventually be available to citizens ineligible for more heavily subsidized health insurance plans, and also not covered as a full time employee of a company with an adequate plan.”

The definition is convoluted, but as Medicaid recipients are for the most part unable to afford private insurance, and many full time employees are able to, the public option is clearly aimed at an “in between” financial situations.  However small its target groups turn out to be, they’re logically part of the puzzle of bringing everyone in to a health insurance system.  A public health insurance option also isn’t just “mopping up” the halt and the lame, as one commenter at Aziz’s post seemed to imply — a pool of the unemployed, the self-employed, and employees of small businesses would generally be about as healthy as the rest of the country.

Aziz concludes:

“So the scope of the public option is limited to begin with, and certainly will be constrained so heavily that it will never, ever be the stealth road to single-payer that most of the progressives who are intent on making it a litmus test seem to think it will.”

Now it’s true that I would have much preferred the public option to be available immediately, rather than by 2013, and I’d have preferred to be able to switch into it from my current employer based health insurance if I so desired.  Both improvements would have made the public option a much more direct competitor with private insurance companies instead of an indirect one I’ll only be able to choose if unemployed.  But Aziz’s prediction still combines at least two assertions I question.

Read the rest of this entry »

2010 Health Care Pledge for a public option or single payer health care system

Public option supporter, 9/13/09

The goal of this pledge is for Americans who support either a “public option” or a “single payer” health care system to motivate their representatives and senators in the strongest way possible: by withholding any support from candidates who failed to vote for a bill including either provision.

The pledge:

We, the undersigned, pledge not to support and to oppose *any and all* incumbents (Democrat, Republican, or otherwise) in the Senate or House in 2010 who

(1) voted against each of (a) a public option and (b) a single payer health care reform bill (HR 676) in the 111th Congress when the opportunity before the full House or Senate arose, or who
(2) demonstrably prevented the possibility of such votes (e.g., by voting to allow filibusters to continue), or
(3) who voted for a reconciliation bill that failed to incorporate either a public option or single payer option, or
(4) — if no such votes take place — who failed to co-sponsor such reforms or vote for them in applicable committees.

By “support,” we mean
(1) contributing money to,
(2) working as campaign volunteers for, or
(3) voting for such incumbents.

By “oppose,” we mean supporting suitable primary challengers to such incumbents whenever possible, and supporting suitable third party challengers in the general election whenever that is necessary to provide a choice for single payer or public option health care reform on the 2010 general election ballot.

By “public option,” we mean an immediate public option, not one “triggered” by future events (since experience shows Congress routinely ignores such triggers), and not a system of “regional coops” (since these are likely to create a “race to the bottom” state with the weakest health insurance legislation).

This petition is not affiliated with any organization, but those who sign it will have self-identified as people who will only support proponents of meaningful, structural health care reform, and should seek out such candidates.

Once health care reform situation is clarified by final votes or filibusters, I’ll do the following:

• Provide a list of “F’s on health care reform” — Senators and Representatives who have failed to meet any of the four conditions above, and where possible, a list of their primary and/or general election opponents.
• Notify suitable challengers (who do support single payer or public option) to these candidates of the possibility of petition signers’ support by directing them to the petition.
• Contact petition signers with an message seeking permission  to send occasional additional messages as the 2010 election campaign season proceeds, and suitable challengers to “F’s on health care reform” are found.  I will not provide any petition signer’s email addresses to any candidate.

This space will serve as a place for updates on the progress of the petition and the progress towards a public option or single payer health care system.

Public option rally, Sunday, September 13, 2009, north of the Capitol.
Organized by “Americans United for Health Care and Insurance Reform“

I joined about a thousand other people from around the country for a rally near the Capitol Building on Sunday.  I was impressed with how energized people seemed to be, at least compared to my own somewhat glum assessment of the situation after Obama’s speech last week. The slideshow above shows a sampling of the signs on display; my favorite was a young man whose signs bowdlerized biblical verses like Matthew 6:26 to “Look at the birds of the air; they do not pay taxes yet your Lord feeds them. … They must be SOCIALISTS.”

It was a reminder that optimism and humor beat pessimism when you want people on your side.  So maybe my fellow demonstrators had it right when they cheered speakers’ mentions of Obama’s speech; while I felt Obama artfully threw the “public option” under the bus, maybe I’m wrong about that after all, and what good does it do me if I’m right?

The rally was a true grass roots effort, bringing people from all over the country.  A woman from Asheville, North Carolina told the terrible story of her son’s death from colon cancer — and from the insurance companies refusal to pay for needed tests and treatments.  Another woman from Michigan told about holding down four jobs and not seeking medical help for an infected jaw — for four years.  A doctor from Texas told about how ashamed she was when an injured patient’s first reaction after regaining consciousness on respiratory support was to panic — and finally explain why by writing out the message “I can’t pay for this.”  These people came a long way to share their stories; they’re not giving up, and so neither will I.

Some of the recent political news isn’t great — e.g., Senator Harkin (Kennedy’s replacement for the HELP Committee saying dropping the “public option” isn’t a dealbreaker, Senator Snowe saying she’ll vote against it, Obama not meeting with progressive Congressmen and women.  But at least one analyst thinks it’s too early to count out the “public option”.  Writing in the Huffington Post, author and political consultant Robert Creamer points out that (1) it’s the push for a bipartisan deal that seems to be fading, (2) four of five congressional committees have reported out a “public option” in their bills, (3) Obama’s support for the idea matters, as does his support for holding down costs — and the Massachusetts model lacking a public option is seeing rising costs, and (4) likely 2010 voters favor a public option by 62 to 28 percent.  I’d take issue with Creamer’s description of HR 3200 as a “strong” public option, but that’s beside his point, which is simply that it ain’t dead yet.

Congressional progressives like Keith Ellison and Raul Grijalva don’t seem to be throwing in the towel, either, and are conducting a “whip count” to gauge the strength of their position that any reform must include a public option.  Ellison thinks 80 to 100 representatives will pledge to oppose any legislation that doesn’t include a “public option”; Grijalva thinks that’s a little high, and told the Huffington Post’s Ryan Grim the whip count will “send a message to the administration: don’t cut deals with some elements of our party or with some elements of the Republican Party without including the progressives in that discussion.” That kind of “deal cutting” formulation may or may not be a good sign, but obviously the higher the count the more insistent he and his allies can be.

Locally, Donna Edwards is a co-sponsor of HR 676 (Conyers single payer bill) and is among those insisting on a public option.  Meanwhile, my own representative Chris Van Hollen has been MIA despite pledging support for a single payer bill in last year’s election — leading Gordon Clark to ask “During this battle for  health care, where in the world is Chris Van Hollen?” It would be good if he got off the fence on this issue, at least.