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LB in SF
Atrios? What am I missing here? 
13th-Sep-2009 06:58 pm
In an entry dated today, Atrios (Duncan Black) expresses "cautious optimism" about Obama's plans for health care reform, based on some remarks that Obama just made in Minneapolis.

Breaking with the healthy skepticism that is usually the signature element of his blog, Atrios says:

"While this process has been rather maddening, I've still remained just on the side of cautious optimism about the final result of health care reform. I don't expect it to be awesome, but it might be just be good enough."

But Obama's speech that Atrios and Digby link to for "new hope" sounds like it does nothing except reiterate support for the crippled "public option" proposal that will insure, at most, 10 million additional people above the current Medicare rolls [- correction, 9/14-LB].

It wouldn't be exactly nothing to establish a safety net for 10 million people who don't currently have (and can't afford to buy) *any* insurance. But the rest of the citizens of the U.S. need more than that and deserve more. I can't see anything in the "co-op" shopping plans that Obama seems to be supporting that will reduce the obscene prices the insurance companies can and do charge the 200 million 45 million of us [thanks wild_irises for catching that] who don't qualify for "group" insurance.

That's good enough? (By the way, I'd definitely like to see more information about what would happen to the employer-funded "Group" plans under Obama health care reform. If the Republicans have their way "Health Care Reform" may also tax those out of existence.)
14th-Sep-2009 06:01 am (UTC)
I knew that couldn't be right. The article you link to says 200+ million people have group-based health insurance, and 45 million (or so) people (including noncitizens) don't. I don't know where that 10 million number comes from, but my understanding is that the Obama plan, whether it has the public option (which of course I support) or the "cooperative" option, is designed to insure every citizen. How well it will work is, of course, open to question.

Like Atrios, I am cautiously optimistic. One thing that makes me so is the awareness that both Social Security and Medicare started out weaker than they are now, faced enormous, passionate opposition, and then were comparatively easy to improve once they were in place.
14th-Sep-2009 04:15 pm (UTC)
Thanks for catching the mistake in re "total population with private insurance" (i.e., covered by private insurance companies) vs. total population with non-group coverage or none at all.

The estimate that the "public option" being proposed in July and August would cover at most about 10 million additional people comes from sources like this, discussing the House bill proposed in July:

"Both the exchanges and the new government health insurance would start in 2013.

* Creates an independent agency, the Health Choices Administration, within the White House to work with states to oversee the proposed new health insurance exchange and set benefit standards.

* Insurers would be barred from excluding coverage for those with pre-existing medical conditions.

* Higher penalties for insurers that give false information to Medicare.

* Congressional aides said about 9 million people would be insured by the public plan, with 21 million insured by private companies in the exchange by 2019.

* Another 164 million would be insured through their employers.

Also a July report from the Congressional Budget Office (Charles Rangel's letter), and this: a letter from a member of the House Ways and Means Committee estimating that an "expanded Medicaid" option would allow another 10 million people to be insured.

Obama, in his recent Minneapolis speech, was still talking about the "Exchange" as the proposed solution at the heart of his reform package, with the "public option" being just one of the competing agencies in the Exchange. I didn't hear any change in this from the plan, above, that was being bruited about in July and August.

That was back in July. If anything's changed, since then, I wish Obama would mention it.

FWIW, here's Brad De Long weighing in on the subject.

Edited at 2009-09-14 09:25 pm (UTC)
14th-Sep-2009 12:57 pm (UTC)
Sadly, the best I can manage to hope for, considering how much the plan has been watered-down and how much more dilution can be expected, is that some kind of bill will pass, and thus establish the basic idea that the Federal Government does have some responsibility for helping assure at least some reasonable minimum level of health-care for everyone in the country. The plan as it stands now seems destined to do very little to advance this, but there might be some significant improvement during the next thirty or forty years. (The worst-case scenario, I suppose, is that it won't work at all, or at least not noticeably, and this will be accepted by the majority of the voters as conclusive evidence that Government can't do anything successfully and shouldn't try.)
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