Howard Dean on The Ed Show: Obama has NOT taken single payer off the table

he just set Ed straight when Ed said that the Obama Admin took single payer and Dean set him straight. thank you, Dr. Dean!

in this environment and what he does.

In the case of the torture situation, he has done just about everything he can to release information to prod action. What he says is different, more politically shaded. He has to surf both sides of all of these issues -- the actual policy decision and the political side.

He always said he'd give us the option to keep our own insurance if we wanted (which is why I liked his plan over Hillary's).

over some of Obama's milder-sounding words, and then fail to notice his not-so-mild deeds.

The poster is suggesting that more attention be paid to those deeds, than those words.

What the poster may not fully appreciate is that it doesn't matter: those who want to bitch at Obama will continue to do so, regardless of to which attention is paid.

If you have never had an expensive illness, you don't have a clue about how good it is, and no rational reason to "want" to keep it. (The irrational reason is that you don't want to be bothered with the hassle.) Private insurers take money from healthy people and REMOVE as much of it as possible from the pool of money devoted to actual care. That means you have volunteered to make the public option an underfunded dumping ground for the seriously ill.

which is why I want to KEEP the insurance and doctors I have now. I have extremely bad MS and my insurance is the BEST. It allows me to have home healthcare nurses, new wheelchairs for free (my wheelchair is worth $36,000), and of course covers all my medications which would cost me about $2,500 a MONTH without my insurance.

So please don't lecture me. I just want to keep what I have as Obama said we'd be able to do-at a lower cost.

Keeping your insurance guarantees that others will go without, as private insurance steals major bucks from the total pool of health care dollars to waste on profits and overhead. You don't need to keep your insurance to keep your doctors.

Obama is flat out wrong about lower costs. Keeping private insurance is a guarantee that there will never be enough money to provide others with what you have. By defending that option, you are assenting to the deaths of others like yourself.

Official Transcript: http://edlabor.house.gov/documents/111/pdf/testimony/20090423DavidHimmelsteinTestimony.pdf

Video of testimony: http://www.youtube.com/watch?v=p-mpadKoFB4&feature=channel_page

A health reform plan that includes a public plan option might realize some savings on insurance overhead. However, as long as multiple private plans coexist with the public plan, hospitals and doctors would have to maintain their costly billing and internal cost tracking apparatus. Indeed, my colleagues and I estimate that even if half of all privately insured Americans switched to a public plan with overhead at Medicare’s level, the administrative savings would amount to only 9% of the savings under single payer.

because I DO have a VERY expensive illness and want Obama to keep his promise? I have enough problems. I don't want to have to start over in a different system. Sorry for wanting to continue my state of declining health with the insurance I now have (I can't get much worse) for the convenience of others. :eyes:

Only the payer changes. What in fucking HELL are you going on about with this "convenience" bullshit? You don't care that being uninsured and uninsurable is a death sentence for a lot of other people? That goes way beyond mere "inconvenience." None of the un- or underinsured people in your situation deserve what you have?

I don't WANT Obama to keep his promise to shitsain private insurance sociopaths.

First you tell me I must be healthy, then you change your argument. What I'm going on about is that my insurance will change and my new insurer may not cover the advanced equipment I need that IS covered with the insurance I have NOW. I know that Medicare does not cover the things covered by my insurance provider. And I NEED the things I have now. But what do YOU care? Just keep cursing. I DO want Obama to keep his promise and I hope he does. People will have a choice to keep their own insurance provider or have govt. provided insurance.

--starves it of cash. If we put all of the health care dollars we are now spending into Medicare for everybody, then everything you need would be covered. It is absolutely insane to think we can't cover everything, given than we spend twice per capita what every other industrialized country in the world spends.

I not only care that you have what you need, but also I care about all those other people in your situation who are NOT getting what they need. Your good fortune is killing other people, and this is unnecessary because everybody in your situation, including you, could be covered if most of the money we spend on health insurance actually went to providing CARE instead of profits and administrative bullshit.

Government provided insurance will suck as long as people like you insist on starving it of cash by feeding private insurance instead. You want to kill other sick people. I'd understand if we did not actually have the wherewithal to care for your needs and those of all similarly situated people, but this is not the case. We can. So your cheerleading for the deaths of others is unnecessary, and deserves more rudeness than I've shown so far.

are going to have the GOVT. make your medical decisions for you. :eyes:

Right now most insurance companies make your health care decisions for you but th GOP always fails to mention that part.

when Howard Dean was governor. I was dubious of him then but he has won me over of late. GO DR. DEAN!

then, when asked about single payer.

the Best Ideas haven't been done yet. HELLO Gibbs.

that really pissed me off.....
stupid, dismissive answer.

He says one thing the Pres says another and then he ends up backtracking...I get the feeling their manipulating the press on purpose.

http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=132&topic_id=8389770&mesg_id=8389770

"Apr 27, 2009

At a meeting with reporters on Friday, Senate Finance Committee Chair Max Baucus (D-Mont.) said he will temporarily set aside talks on a new public insurance option to focus on maintaining employer self-insurance plans, CQ Today reports. Self-insured companies qualify for tax exemptions through the Employee Retirement Income Security Act. The federal law allows firms to create their own tax-exempt insurance plan -- a means of cutting costs by taking on the risks themselves -- as long as the plans meet federal standards laid out by ERISA. Firms contract with private insurers to administer the plans. Baucus said he would aim to preserve this self-insurance system while expanding private coverage and public programs such as Medicaid. He said, "We'll end up with more private insurance and more public insurance" (Armstrong, CQ Today, 4/24).

As for the creation of a new public insurance option, Baucus said that it is "on the table," adding that it "might be to the side a little bit, ... but it's still on the table." He added, "We're trying to get momentum going. We'll get to the public option a little later. Let's not forget: There's an awful lot more here than the public option" (Young, The Hill, 4/24).

Baucus said he would support a "system similar to Massachusetts," which allows residents to buy coverage through a "connector" offering plans that meet government-established benefit minimums"

He wants mandatory requirements to make us buy insurance. That is not health care reform.

He was forced into allowing Single-Payer a place at the table. The health care industry has Obama on this one. Change - but it's really going to only be tinkering - UNLESS - it's Single-Payer!

Here's the best single-page resource on what Single-Payer is all about:
http://www.pnhp.org/facts/single_payer_resources.php

Obama was always for the public option. He campaigned on it.

A public option could not compete with the private market and their marketing dollars.

http://www.pnhp.org/

Single-Payer Or Bust!

Bernie Sanders on THE ED SHOW:
http://www.pnhp.org/news/2009/april/ed_show_bernie_sand.php

http://www.theliberalcurmudgeon.com/2009/05/sen-ben-nelson-public-health-plan-too.html

A poll released this week by Consumer Reports National Research Center showed that 66 percent of Americans back the creation of a public health plan that would compete with private plans. Nelson, in comments made to Congressional Quarterly, joins the 16 percent of poll respondents who said they oppose the plan.

Nelson's problem, he told CQ, is that the public plan would be too attractive and would hurt the private insurance plans. "At the end of the day, the public plan wins the game," Nelson said. Including a public option in a health plan, he said, was a "deal breaker."


So Nelson's "problem" is that too many people want public health insurance–and the "deal breaker" is that it would hurt private insurance. On the issue of health care, Nelson is not a public, but a "private," servant.


I must say that Nelson is at least honest about his reasons. He didn't offer the usual nonsense about how privatized health care, which results in 47 million uninsured Americans, is the best system we can have. There's something refreshing in his candor, yes?

...

Senator Nelson represents Nebraska. Omaha is the health insurance capitol of the country. I'm not surprised.

it wouldn't be a threat to the insurance companies, and Nelson wouldn't be screaming his fool head off about what a danger it was.

If it couldn't, the insurance industry wouldn't be trying so hard to defeat it.

Private insurance could not compete with the public option. That's why Republicans and people like Ben Nelson are against the public option.

Should PNHP support a public Medicare-like option in a market of private plans?

Health Policy Q&A with PNHP Co-founders Drs. David Himmelstein and Steffie Woolhandler on 04/17/2009


PNHP should tell the truth: The “public plan option” won't work to fix the health care system for two reasons. .

1. It foregoes at least 84% of the administrative savings available through single payer. The public plan option would do nothing to streamline the administrative tasks (and costs) of hospitals, physicians offices, and nursing homes. They would still contend with multiple payers, and hence still need the complex cost tracking and billing apparatus that drives administrative costs. These unnecessary provider administrative costs account for the vast majority of bureaucratic waste. Hence, even if 95% of Americans who are currently privately insured were to join a public plan (and it had overhead costs at current Medicare levels), the savings on insurance overhead would amount to only 16% of the roughly $400 billion annually achievable through single payer.

2. A quarter century of experience with public/private competition in the Medicare program demonstrates that the private plans will not allow a level playing field. Despite strict regulation, private insurers have successfully cherry picked healthier seniors, and have exploited regional health spending differences to their advantage. They have progressively undermined the public plan—which started as the single payer for seniors and has now become a funding mechanism for HMOs, and a place for them to dump the unprofitably ill. A public plan option does not lead toward single payer, but toward the segregation of patients; with profitable ones in private plans and unprofitable ones in the public plan.

Would a public plan option stabilize the health care system, or even be a major step forward?

The evidence is strong that such reform would have at best a modest and temporary positive impact—a view that is widely shared within PNHP. Indeed, we remain concerned that a public plan option as an element of reform might well be shaped in a manner to effectively subsidize private insurers by requiring patients to purchase coverage while relieving private insurance of the highest risk individuals, stabilizing private insurers for some time and reinforcing their control of the health care system.

Given the above, is it advisable to spend significant effort advocating for inclusion of such reform? No, for two reasons:

1. We are doctors, not politicians. We are obligated to tell the truth, and must answer for the veracity of our stance to our patients and colleagues over many years. Ours is a very different time horizon and set of responsibilities than politicians'. Falling in line with a consensus that attempts to mislead the public may gain us a seat at the debate table, but abdicates our ethical obligations.

2. The best way to gain a half a pie is to demand the whole thing.

Is fundamental reform possible?

We remain optimistic that real reform is quite possible, but only if we and our many allies continue to insist on it.






If we have to compromise at the end of the process, what should a public option look like?

This opinion article is compiled from conversations held during April, 2009, with health care reform advocates, including Physicians for a National Health Plan, Health Care for All NJA? and other advocates.
This draft (4-18-09) prepared for discussion, by Craig Salins

In other words, if we can’t get our pony, what should the kitten that we will settle for look like? Congress is finally considering serious health care reform, pushed by the Obama administration and by a worsening crisis nationwide. There are several competing options and proposals, representing a diversity of interests, each seeking to broaden coverage to all or most Americans and at an affordable cost.

One proposed option is simply to expand Medicare to everyone. It would cover all Americans, all ages, be financed publicly, and delivered privately through existing local health services and facilities.

Another option is to leave existing private insurance plans in place, for any Americans who want to keep their existing plan, while simultaneously establishing a public plan which would be open anyone—those who don't currently have coverage, or who desire to switch to a public plan. The expectation is that such a public plan would provide good benefits at a lower price, by operating on a non-profit basis, with a single risk pool nationwide, without expensive overhead.

But such a plan could be hijacked or derailed in Congress by special interests. If not designed with safeguards and combined with tight regulation of private insurance, a public plan could become simply a dumping ground for older, sicker enrollees at taxpayer expense, while letting the insurance industry reap a bonanza in public subsidies and profit: for enrolling healthy people who cost very little.

The insurance industry is already opposing the creation of a public plan option. They complain that it would compete with their established plans (it would, of course—fair competition is the point.) But the insurance industry might use their political clout through Congressional debate to “shape” the public plan so that it cannot succeed—or so that it works to their advantage, perhaps by taking sicker, more costly patients off their hands, leaving low-cost healthy patients to be milked for higher profit.

A public plan option must be designed with the public interest in mind—and not by those in the insurance industry who have private profit in mind at taxpayer expense!

These features below must be part of any public plan option—to achieve a plan that will work for all.

1. Any public option should directly pay providers (like Medicare does) - using a single, efficient public “payer” to pay for services delivered by private health care providers and facilities chosen by the patient. (This contrasts with a referral or “connector” plan, such as the Federal Employee Benefits Health Plan, that simply enrolls people in existing private insurance plans. A connector scheme is expensive, due to an extra layer of administration to broker the arrangement and the expensive overhead of private insurance.)

2. Comprehensive benefit package, one set of benefits for everyone regardless of age, employment status, enrollment group, geography, health status, or any other factor.

3. Free and complete choice of health care providers, including hospitals, clinics, all services.

4. Affordable. No excessive co-pays or deductibles. Appropriate cost-sharing from employers, individuals, and from public sources/programs such as Medicaid and Medicare.

5. Available to everyone including employers, employee groups, and any individual.

6. Guaranteed acceptance* No denial of coverage to anyone for health status, pre-existing conditions, or for any reason. No waiting period. No penalties for not previously having insurance.

7. Immediate enrollment and coverage* in a plan of patient's choice, at the point of first medical contact for those not previously enrolled in a coverage plan. No delay when coverage starts.

8. Community rating* Insurance premiums based on health care risks and costs for the entire population - not on any particular subset of risks and costs, such as those with chronic disease.

* These features should apply by law to all health care insurance - public or private - as a matter of public policy.

Also, if for now, Congress fails to enact HR 1200, HR 676, S 703, or a similar single-payer plan, such that private for-profit health insurance coverage continues to be part of the national mix of options—

There must be robust and effective regulation of private insurers:

1. to limit overhead administrative costs and investor profit (as is done now with regulation of public utilities); and
2. to prevent "cherry-picking"—enrolling only the healthy, and excluding those with pre-existing conditions or chronic disease, etc.; and
3. in general, to prevent the public plan option from becoming a taxpayer-supported dumping ground of sicker patients, while private insurance reaps a windfall from enrolling only the healthy.

Regulation of private insurance plans must include—at a minimum—the features above marked by (*).

Private insurance is the problem

Rather than solving the challenge of affordable health care for all, private insurance IS the problem.

Why? Because real savings can only be realized by eliminating the inefficiency that is built in to the private health care insurance system. A public option plan foregoes at least 84% of the administrative savings available through a nationwide single payer system—publicly-financed, covering everyone, and delivered through private and community-based providers of the patient's choice.

When there are hundreds of private insurance plans, hospitals and doctors need an army of clerks to handle all the different rules and limitations in processing payment and claims. Also, under our current system, the insurance industry spends greatly on screening efforts to “cherry pick” only the profitable enrollees, by excluding those with pre-existing conditions and chronic illnesses. The net effect is profitability for insurance companies, but too many uninsured, and higher costs to the public.

Until and unless there is a single-payer system, effective cost control depends on tight regulation of private insurance, to limit overhead costs where too many health care dollars are actually wasted—such as for marketing costs, investor profit, excessive compensation to CEOs and top management, corporate lobbying and campaign contributions, etc.

A private option is always out there.

Single-payer was a natural development for former Warsaw Pact countries, because under Communism there was no private insurance industry. Taiwan provides the most successful example of the implementation of a single-payer system in a nation where private insurance previously existed.

if he had walked in with only that on the table, that would have been the end of the conversation. this way he gets to point to how much support there is out here in the real world.
the man is a very, very good lawyer. he speaks very carefully. you have to listen very carefully if you want to know what he means.
he was always for it. he still is.

of what is capable of passing in the Congress and what isn't. Would be great if he would just insist that bills go to the floor as is and let them fail. All or nothing at all, is where it's at.

fierce pragmatism. that is his game.

when a bill goes through the House or the Senate, and nobody seems to care, until it's over. Kind of like how the voting systems in different states don't matter until after people vote...and then the candidate is supposed to fix it, or how everything will be okay when so-and-so is voted out in the 'next' election. As if that helps. I was being sarcastic in the previous post about all or nothing. Should have been clearer I guess.

is actually an opinion, and proclaiming that one is pragmatic is like proclaiming that one is correct. And those that do not attempt that which is difficult are not pragmatists but pessimists. Whining that something is difficult, or that it is not a garunteed win, is not a real reason to give up in advance of making an attempt.
Assuming defeat is not pragmatism.

Single-payer is now being used to describe a public option.

:(


http://www.democracynow.org/2009/3/11/dr_quentin_young_obama_confidante_and

"While the Obama administration claims “all options are on the table” for healthcare reform, it’s already rejected the solution favored by most Americans, including doctors: single-payer universal healthcare. We speak with Dr. Quentin Young, perhaps the most well-known single-payer advocate in America. He was the Rev. Martin Luther King’s doctor when he lived in Chicago and a longtime friend and ally of Barack Obama. But he was noticeably not invited to Obama’s White House healthcare summit last week...


AMY GOODMAN: This brouhaha over the last week with the White House healthcare summit, 120 people, there were going to be no single-payer advocates. Congressman Conyers asked to go. At first, he was told no. He directly asked President Obama at a Congressional Black Caucus hearing. He asked to bring you and Marcia Angell—


DR. QUENTIN YOUNG: Yes.


AMY GOODMAN: —former editor-in-chief of the New England Journal of Medicine. You weren’t allowed to go. Do you have President Obama’s ear anymore? You have been an ally of his for years, for decades..."

following the single payer saga for a while now and keep losing some of the important stories.

That's ridiculous self-praise from internet slacktivists. What actually happened was that Obama had announced several members of his upcoming health-care reform council. There was no single-payer advocate in those few. A handful of people shrieked in outrage that single-payer was "off the table." Of course, as it turned out, Obama did end up announcing that single-payer representatives would have a seat at that table; he had only announced a fraction of the attendees when the internet outrage machine started cranking.

Did the shriekers say, "oh, guess we were wrong, ha ha, it was kind of silly to assume without any particular cause that Obama was not actually going to give a voice to a major ideological perspective on health care?" No. They, of course, chose to credit themselves, because that's much more fun.

I'm sure roosters credit themselves for making the sun rise, too.

and i'm sure he hears the good dr's voice in his head.

opening up medicare to all who want it as an option while everyone who likes their private plans can stay there. I think a lot of people would opt for the public option, because of the cost.

I have to say, i like howard dean. he is a straight shooter who doesn't get flustered and has confidence in his arguments.

Single-Payer doesn't mean hundreds of payers with one public payer. Single-Payer means just that - SINGLE payer. As in - one.
http://www.pnhp.org/facts/single_payer_resources.php

Having a public option is one way to get us there.

and seems to equate the two.

"...what Obama's plan essentially does is give you the choice of whether you want to be in a single-payer or private insurance market..."

:shrug:

the table.

maybe Gibbs was wrong, but SP advocates are not being given much room to have their views heard.

Gibbs goes on to joke about not getting a baseball stadium and how there are 535 members of Congress, but how many members of Congress have introduced legislation for a health care plan for the last several years???

:(


http://www.whitehouse.gov/the_press_office/Briefing-by-WH-Press-Secretary-Gibbs-3-5-09/

"2:55 P.M. EST

Helen. Yes, ma'am.

Q In that respect, I want you to reconcile two things.

MR. GIBBS: Okay.

Q In prepared remarks the President said every voice must be heard. He also said, "I want it to be clear at the outset, everyone has a right to take part in the sessions." But you have barred two people who are strongly for single-payer. And Conyers had to beg to come.

MR. GIBBS: Who was barred?

Q You barred Dr. Angell -- Marcia Angell and Dr. Quentin Young, both staunch advocates of single-payer Medicare for all.

MR. GIBBS: Well, I am pretty sure that their -- those viewpoints are represented in that room.

Q Why were they barred?

MR. GIBBS: I will certainly check on -- I told Chip we rented a big room, but we didn't get the Nationals' baseball stadium. There's a lot of people that are involved. There were a limited number of seats, but a lot of different viewpoints. We could have had 535 members of Congress, in addition to all these stakeholders, because I think everybody is going to be involved in this.

I would also say I think this is the first of many discussions and many issues --

Q I think it was quite an insult to Conyers.

MR. GIBBS: Well, I -- look, there were a lot of members of Congress that wanted to come and were added to the list. Again, I think there's a lot of people that are involved in this process; the bill will go through many committees and I think -- I think a lot of different viewpoints will be expressed today. And I think many of those viewpoints will have somebody to make them.

Q Why is the President against single-payer?

MR. GIBBS: The President doesn't believe that's the best way to achieve the goal of cutting costs and increasing access."

thanks once again for a great link.

attention.

:shrug:

"Dr. Dean stated that single payer is NOT off the table--YAY!--then proceeded to redefine single payer. A multi-payer health care system with "public insurance" as one option is NOT single-payer."

Welcome to DU.

It is remarkable how people twist themselves into pretzels trying to justify what cannot help but appear to be bait and switch with appeals to muddy statements, hope and 'chess moves'.

From: The People.

The people of this country want single-payer universal health coverage. It is high time our representative in Washington get the job done.

SINGLE PAYER WAS NOT AND IS NOT ON THE TABLE.


Toast






http://www.1payer.net/action-alerts/260-heroes.html



Single Payer Heros
Tuesday, 05 May 2009 11:46 Clark Newhall
E-mail Print PDF

Dr. Margaret Flowers and other single payer advocates took direct action this morning and got carted off to jail. Fifteen of our allies demanded to know why single payer ws not even allowed a seat at the table yesterday during 'Mad Max" Baucus's Senate Finance Committee sham hearing on insurance-company-friendly fake 'reform." Look at the video here.

Notably, Baucus made mouth noises about the 'respect' he has for single payer advocates. Apparently , his respect does not extend to allowing our ideas to be heard in Congress. Meantime, his Senatorial colleagues were joking and laughing about the protest, paying it no attention. Yet, the clowns at the testimony table, including Karen Ignoble Ignani, were accorded the greatest respect by the clowns at the hearing table.

Margaret and those who were with you -- you are HEROES. You make us proud. Each of us can take a lesson from you and each of us must do what we feel is the most we can do. Without all of us acting together, more millions will die through the mis-managed and neglectful health insurance driven non-system.

Baucus, your hypocrisy makes me ill. Obama, you are complicit in this crap.Journalists, your silence on single payer shows where your real professional allegiance lies -- in your pockets with the big business money that lines them.

Here are the folks who were arrested this morning:

Katie Robbins
Russell Mokhiber
Kevin Zeese
Carol Paris
Margaret Flowers
Mark Dudzic
Jean Fox (?)
Adam Schneider

Last Updated ( Tuesday, 05 May 2009 12:46 ) :fistbump: :fistbump: :fistbump: :fistbump: :fistbump: :yourock: :yourock:

We'll see who's laughing come primary election time.

I don't think President Obama knows that he is now for single payer after he said he was against it after he spoke out for it when a member of the U.S. Senate.

So Howard Dean needs to inform President Obama of his current position on single payer just in case he doesn't know what his position is today.