Washington Lobbyists Pedal Power

The equivalent of six health-care lobbyists for every member of Congress are registered for this year's biggest political battle.

http://features.csmonitor.com/politics/2009/09/28/how-washington-lobbyists-peddle-power/

Wolf Blitzer asks David Axelrod some Tough Questions

http://www.cdobs.com/archive/featured/a-first-wolf-blitzer-ask-david-axelrod-some-tough-questions,64456

Ed Morrissey

BLITZER: Why not break down the state barriers and let all of these insurance companies compete nationally without having to simply focus in on a state by state basis?

AXELROD: Because we are trying to do this in a way that advances the — the interests of consumers without creating such disruption that it makes it difficult to to move forward.

BLITZER: Why would that be disruptive? If Blue Cross and Blue Shield or United Health Care or all of these big insurance companies, they don’t have to worry about just working in a state, they could just have the opportunity to compete in all 50 states?

AXELROD: But insurance is regulated at the — at this time, Wolf…

BLITZER: But you could change that. The president could propose…

AXELROD: …state by state.

BLITZER: The president could propose a law…

Jesus...Notorious D.O.C.

So let me understand, conservatives by nature are God-fearing people.

God last time I checked wanted us to be kind to each other. Jesus, as we all know, was prolific as a healer. So if you go according to the lovely marketing strategy …

W.W.J.D?

Would he say David Flores can leave the hospital after being struck by a car? Would he wait for two weeks before the back specialist would see him?

I always thought one thing, I could do a lot of things wrong, but many of them wouldn’t break my mother’s heart? Try having to bury a child.

Would he say universal health care is his father’s will?

Would he say any man regardless of his background or experiences deserves medical attention?

Would he say please don’t allow another person to die because it cost too much?

How much is a life worth to you? How much is your child, mother, father, wife, husband worth to you?

Wow people! Jesus cured the sick, brought the dead back to life, he never said…

Sorry Blue Cross Blue Shield won’t cover him. Eventually we are going to have to ask ourselves are we so consumed with our own insular world that we could care less about someone else? The question is when we are the sick person, when we are the “unlucky” will we say…HELP ME JESUS!

Jesus has not returned, but there are doctors that are healers, that can make the sick well. When are we going to love one another as Jesus wanted?

I write this for many people, but mainly for David and his family. For your loss I'm so sorry.

Town Halls: If Congress really cared about what you think

Town Halls: If Congress Really Cared What You Think. . .
By Jane Orient
Published 09/22/09

After the town halls are over, and congressmen head back to Washington, possibly to do whatever they had already decided based on high-level threats or promises, many citizens are asking, exactly what was the point?

Our Blue Dog Democrat congresswoman, for example, billed her town hall as a "listening session"—but for whom? People jamming the auditorium and the more than 1,000 seated outside listened for half an hour to introductory remarks by Persons of Importance. During the remaining one-and-a-half hours, she took about 15 questions. In her answers, she "recited parts of her stump speeches, extolling the virtues of Cash for Clunkers, the Stimulus, Medicare, Medicaid, and Tricare," according to a physician attendee.

The audience learned a few things about her positions, in the most general terms. She said she’s opposed to single payer, for tort reform, strongly supportive of a public option, and opposed to anything "that is not actually paid for."

She and the press complained about a "boisterous," "rude" crowd, whose boos and cheers sometimes drowned out the speaker. Especially the cheers in response to the suggestion to vote the entire Congress out in 2010. Of course, the "applause meter" was the only method available for most members of the audience to express themselves.

The fact that the attendees were evidently opposed to "reform" by a margin of 2 to 1 or 3 to 1 apparently did not register with the press—which didn’t mention it. Or with the congresswoman, who thought people were mainly "frustrated with a broken system."

If Congress really wants to learn from constituents, isn’t the process backwards? Why doesn’t the representative, at some point, ask the audience for a show of hands on some basic questions? For example:

Do you favor or oppose rushing reform through without hearings or adequate time to read and debate the proposal?

Do you trust the government to run a health insurance company?

Do you think Americans should be forced to buy health insurance, and the kind of health insurance the government dictates?

Do you favor or oppose a federal health board, modeled on the Federal Reserve, to make decisions affecting the availability of medical services?

Do you favor or oppose a health plan that will increase the federal debt?

Do you favor or oppose giving the Internal Revenue Service access to your financial records to be sure you are paying the required health insurance premiums?

Of course, these are not the questions most Congressmen are likely to think of. Maybe the audience has to suggest the questions as well as ask for a poll on the answers.

The biggest question of all is why are we even discussing the details, while begging the biggest question of all: Does Congress have the Constitutional authority to do any of the things that are proposed as "health care reform"?

Where does it get the right to outlaw existing private arrangements and contracts? To force Americans into government dependency for paying for their medical care? To set medical standards and prices for medical services? To manage one-sixth of the economy? To decide for individuals what they can afford? To delegate enormous authority over people’s lives to an executive agency to avoid political accountability?

Well, of course there’s Medicare, the big, popular precedent. As Jonathan Swift pointed out in Gulliver’s Travels, if a wrong can legally be done once, precedent assures that it can be done again.

If a one-vote, one-time democracy has the right to turn American medicine over to czars like Zeke Emanuel, then town halls might as well be an orchestrated circus to give homage to our elected nonrepresentatives.

But Congress apparently did not foresee the response this August. Change is in the air. Long-held assumptions are being challenged. America might yet turn back from the road to tyranny, and find the way back to freedom and limited, Constitutional government.


Copyright © 2009 Campaign for Liberty

http://www.campaignforliberty.com/article.php?view=229

Joe Wilson's Dirty Health-Care Secret

 

 
All in the Family: Rep. Joe Wilson (left) and his son, Alan Wilson, who is running for attorney general in South Carolina. Both men, and three of Rep. Wilson’s other sons, get free military medical coverage.

By Adam Weinstein

Poor Joe Wilson. The conservative Republican representative from South Carolina stepped in it Wednesday night when he broke with centuries of decorum by screaming, "You lie!" at President Obama during his health-care speech to a joint session of Congress.

Cut the man some slack. He's passionate! I know this because he told me, in the sole message that blazes across his campaign Web site: JOE WILSON IS PASSIONATE ABOUT STOPPING GOVERNMENT RUN HEALTH CARE!

Except that he's not─at least not when it comes to his, and his family's, government-run health care. As a retired Army National Guard colonel, Wilson gets a lot of benefits (one of which, apparently, was not a full appreciation of the customs, traditions, and courtesies that mandate respect for one's commander in chief). And with four sons in the armed services, the entire Wilson brood has enjoyed multiple generations of free military medical coverage, known as TRICARE.

Yes, it's true. As politicos and town-hall criers debate the finer points of the public option, employer mandates, coverage for undocumented immigrants, and who's more Hitler-like, they seem to miss a larger point: the United States has single-payer health care. It covers 9.5 million active-duty servicemen and women, military retirees, and their dependents─including almost a 10th of all Californians and Floridians, and nearly a quarter of a million residents of Wilson's home state.

Military beneficiaries like Wilson─who, as a retiree, is eligible for lifetime coverage─never have to worry about an eye exam, a CT scan, a prolonged labor, or an open-heart surgery. They have access not only to the military's 133,500 uniformed health professionals, but cooperating private doctors as well─whose fees are paid by the Department of Defense. It's high-quality care, too: surveys from 2007 and 2008 list TRICARE among "the best health insurer(s) in the nation" by customer satisfaction. Yet Wilson insists government-run health care is a problem.

To be fair, Wilson has been consistent in his policymaking if not his personal life: according to his last congressional opponent, Wilson voted 11 times against health care for veterans in eight years, even as he voted "aye" for the Iraq War (during the debate on the war vote, he even called one Democrat "viscerally anti-American"─several times). He voted to cut veterans' benefits─not his own─to make room for President George W. Bush's tax cuts. He repeatedly voted for budgets that slashed funding to the Veterans Administration and TRICARE. And perhaps most bizarrely, he refused─repeatedly─to approve Democratic-led initiatives that would have extended TRICARE coverage to all reservists and National Guard members, even though a disproportionate number of them have served multiple tours in Iraq and Afghanistan─and many lost access to their civilian work benefits when they did so.

There's one other notable exception to Wilson's tough-on-government record: In July, when the health-insurance debate just started heating up, he offered an amendment that would exempt TRICARE from any system of employer mandates in a health-care bill. It's not clear whether this is necessary, since most such bills in Congress keep government benefits exempt from the rules as a matter of course. But Wilson took the opportunity to make his stand.

"As a 31-year Army Guard and Reserve veteran, I know the importance of TRICARE," he said in a press release. "The number of individuals who choose to enroll in TRICARE continues to rise because TRICARE is a low cost, comprehensive health plan that is portable and available in some form world-wide." He went on to call TRICARE "world class health care," concluding on a personal note. "I am grateful to have four sons now serving in the military, and I know that their families appreciate the availability of TRICARE," he said.

What does that mean? Nothing─except that Joe Wilson was against government-run health care before he was for it. And now he's against it again. Just not when it comes to his own flesh and blood.

 Adam Weinstein, an Iraq veteran, is a freelance journalist. He is uninsured.

DEAR FRIENDS: Health Care (or lack of) is VERY VERY REAL

Dear Friends: Health Care (or lack of) is VERY VERY REAL

Sep 9, '09 3:24 PM by MsSnooty for everyone

Teddy Roosevelt first proposed health care for all in the early 1900s. FDR fought for it in the 1930s. LBJ won Medicare and Medicaid in the 1960s but wasn't able to provide coverage for everyone. Bill Clinton tried in the early 1990s. And since Barack Obama was inaugurated in January, Congress has been heatedly debating health care reform. 

We've been talking about this issue for over 100 years. Enough talk. It's time to get something done!

Click here to call your Senators and tell them enough politicking, it's time to get real health reform done.

We've already made historic progress. Three committees in the House have passed strong health reform bills and referred them to the floor. And the late Senator Kennedy's committee has passed a strong bill as well.

Still, some in the Senate are waffling and asking for more time. Give them a call and tell them to support Kennedy's HELP bill that will lower our costs, improve our coverage, and give us the choice of a public health insurance option to keep the insurance industry honest.

This week, the Senate is back in DC. Click here to call your Senators right now, when your call can make the most impact!

We've waited long enough. We can get real reform done this year. Call your Senators today and make them do it!

To your health,

Levana Layendecker
Health Care for America Now

Dr. Andrew Weil: Fear, Greed and X-Rays

http://www.huffingtonpost.com/andrew-weil-md/fear-greed-and-x-rays_b_270828.html
Physicians like to discuss the fear side, because it shifts the blame to lawyers. The greed side, however, deserves just as much scrutiny and reform. Consider "The Cost Conundrum: What a Texas town can teach us about health care," a must-read New Yorker article by Atul Gawande, M.D. Gawande visited McAllen, Texas, to discover why per-capita health care expenditures there are the highest in the nation. He found that many physicians in high-medical-cost cities such as McAllen have a diversified "revenue stream," the result of what one hospital administrator termed "entrepreneurial spirit." This "spirit" often manifested in physicians owning their own medical testing equipment, which meant the more tests they ordered, the more money they made. A 2002 University of North Carolina study showed doctors who own imaging equipment sent patients for roughly two to eight times more imaging tests than those who don't own.

In Gawande's article, a McAllen doctor who refused to hop aboard this gravy train had a more sensible take on the local "spirit." "Medicine has become a pig trough here," he said. "We took a wrong turn when doctors stopped being doctors and became businessmen."

Lest you think the only drawback of over-scanning is wasted billions, note that from 1980 to 2006, per-capita radiation dosage from medical testing more than quintupled. A controversial study published in the November 29, 2007, New England Journal of Medicine estimated that computed tomography (CT) scans -- the type of imaging that has grown most explosively -- administered today could eventually cause up to 2% of cancer deaths.

As with fear, greed also propels expensive, inappropriate treatment. If a clinic loses money each time it counsels a patient to control type 2 diabetes with diet and exercise, but makes a hefty profit when it amputates a foot riddled with diabetic ulcers, how long will it continue to emphasize the former?

Digital Roam: American health care on (4) napkins. Now all together!

http://digitalroam.typepad.com/digital_roam/2009/08/american-health-care-on-4-napkins-now-all-together.html
Digital Roam: American health care on (4) napkins. Now all together!

You can now download my entire series of four "back of the napkin" health care sketches as a single PDF file here.

very nice

Ted Kennedy on Health Care

This speaks for itself.All of his siblings died serving their Country.Isnt it about time we gave something back?Health care is a Ted Kennedy Bill.Pass it!

Down With the Senate

http://www.tnr.com/politics/story.html?id=0cec8e5a-e6d4-428c-8a34-cc5569ce217d
Down With the Senate

The sense most people have of the health care debate is that it's great drama in which President Obama is the central player. All the big news has centered around hints and whispers about what the White House wants. They're abandoning the public plan! They're standing by the public plan! They're giving up on bipartisanship! The press has covered the story as if Obama is Moses and we're waiting for him to come down from the mountaintop.

This is totally wrong. The Senate is what controls the process. That's the chokepoint for any health care bill. The question isn't how badly Obama wants a public plan, or how much he cares about bipartisanship. It's whether moderate to conservative Democrats in the Senate will filibuster a bill that has a public plan or lacks GOP support. Everything else is details.

...


I still think there's a pretty good chance at passing significant health care reform. But if health care reform fails, liberals need to understand who to blame and how to fix it. They need to start knocking off Democrats like Conrad and Joe Lieberman, who seem to be trying to kill health care reform, even if this temporarily costs the Democrats some seats. They need to commit the party to reconstituting the rules of the Senate along majoritarian lines--yes, even if this helps Republicans pass their agenda when they're in charge. If health care reform can't pass now, then a filibuster-proof Democratic majority isn't worth having. At that point you have to consider blowing up the party and waiting a decade or two to rebuild a new one that's able to address the country's actual needs.

unfortunately if this fails, it's pegged on Obama because it's his campaign promise and the reason why people voted for him.

Will the Deficit Save Health Reform? | The American Prospect

http://www.prospect.org/cs/articles?article=will_the_deficit_save_health_reform
Will the Deficit Save Health Reform? | The American Prospect

Despite the president's focus on health care as deficit reduction and evidence that the Congressional Budget Office, charged with discovering the costs of these bills, chronically overestimates the costs and underestimates the savings of health-care bills, most experts think that no feasible bill will bend the curve as much as is necessary to directly slow the increase in spending -- ironically, the cheapest option, single-payer, is politically toxic. Savings that do result from reform will be required to subsidize health care for most of the 47 million Americans who have no health insurance. But even this kind of health-care reform is important for reducing the long-term deficit.

First of all, reform will provide more information to policy-makers. Studies of comparative effectiveness and data from a public insurance plan will provide a deeper understanding of inefficiencies in the system and the solutions to those inefficiencies. The White House Council of Economic Advisers has also estimated that health-care reform will lead to increases in GDP, reaching over 2 percent in 2020 that would lead to proportional increases in tax revenue and lower deficits. But most important, eliminating the "crazy system of cross-subsidies," as Center for Budget and Policy Priorities economist Jim Horney calls the complex interweaving of publicly and privately subsidized care for the under- and uninsured, would create a much simpler framework for future cost-reduction efforts.

"It really is important to get universal or near-universal coverage in order to help create a system that is more sensible," Horney explains. "That system will help us to design [more efficient] reimbursement systems."

or we could just kill Medicare.

Coburn to crying health insurance victim: Go beg for scraps

Go beg your neighbors for the $100M you need to get a speech pathologist and to tend to his nursing needs, and to pay the mortgage and insurance bills for the insurance you aren't getting.

What an ass, him and the infomercial crowd there. even if government isn't the solution, then tell us what is. "Neighbors" is not a credible answer.

I'm glad the un/underinsured are finally getting out there and telling their stories and creating scenes for the "if it bleeds it leads" news media. I hope it makes a difference

So What If Obama Fails? - Page 1 - The Daily Beast

http://www.thedailybeast.com/blogs-and-stories/2009-08-23/so-what-if-obama-fails/
uh oh. are they already writing the epitaph?

Major legislative change is hard, so it should come as no surprise that Barack Obama's drive to comprehensively reform the American health-care system is running into some problems. By contrast, Monday-morning quarterbacking is easy, so it also should come as no surprise that these problems are inspiring a massive wave of second-guessing.

Perhaps the most exhaustive version of the "Obama making mistakes" narrative was unleashed this weekend at Politico by the potent team of Mike Allen and Jim VandeHei, who accuse the president of trying to do too much too soon. In their telling, the administration has relied on a fallacious "big bang" theory of political change, in which economic crisis and an electoral mandate create a good moment for sudden and massive reform of domestic policy. There's some truth to this. Chief of Staff Rahm Emanuel talked during the transition about how it would be a shame to let a crisis go to waste, and liberals have developed a narrative about sudden bursts of political change under Franklin Roosevelt and Lyndon Johnson that are a bit at odds with the facts.

It's not only Clinton who failed to accomplish comprehensive health-care reform--his effort joined reform charges by FDR, Harry Truman, Richard Nixon, and Jimmy Carter on the ash heap of history.

At the same time, critics of the Obama administration's alleged tactical errors should consider that their decision-making has been heavily shaped by the perception that Bill Clinton's drive for health reform was brought down by poor White House decision-making. Thus, while Clinton had the White House develop a detailed plan that was then presented to Congress, Obama outlined broad principles and deliberately left hugely important decisions to the Hill. While Clinton opened with centrist gestures on NAFTA and budgetary balance, only turning to health care seriously in his second year, Obama leapt out of the gate with an effort to tackle health. Clinton proposed large, systematic change in the way health care would work for everyone, hoping to achieve broad-based support for a better system; Obama has promised a risk-averse population that most people's insurance will stay the same.

What Clinton tried didn't work, in other words, so Obama's trying it another way. Now the United States Senate looks reluctant to pass a comprehensive plan, so people think Obama is making mistakes. But looking back at American history, it's not only Clinton who failed to accomplish comprehensive health-care reform--his effort joined reform charges by FDR, Harry Truman, Richard Nixon, and Jimmy Carter on the ash heap of history. Johnson, arguably the most accomplished legislator in American history, was too scared to try and brought us Medicare and Medicaid instead. It defies plausibility to suggest that president after president after president is blundering or inept. Rather, we should just admit the obvious--people keep trying and failing to reform the health-care system because reform is hard to do.

It's hard because most people already have health insurance. It's hard because the segment of the population most likely to worry about health care--senior citizens--already benefits from a generous Canadian-style system. It's hard because the people worst-served by the status quo are also the people least likely to vote. It's hard because the interest-group pressures--not just from insurance companies but also doctors, hospitals, pharmaceutical companies, vendors of medical equipment, and labor unions who've already secured generous benefits for their workers--are intense. It's hard because the issue is complicated and it's hard because we don't have one "health-care system" that can be reformed; instead, the population is segmented into a series of very different situations.

And none of it is made any easier by the fact that the U.S. political system is very resistant to change. In most countries, laws are passed by a unicameral legislature elected to express, more or less, the will of a majority of the population. Under Obama, the House of Representatives--which basically fits the bill--has already passed what would, if it were to become law, be the single most important piece of environmental legislation in the history of the world. They're also poised to pass a universal health-care bill that's already cleared all three relevant committees and almost certainly has majority support. But the House leadership, sensibly, doesn't want to ask potentially vulnerable members to cast another tough vote unless the Senate is prepared to act.

And the Senate, simply put, is rarely prepared to act--60 votes is a very high bar to cross.

It's possible that despite the formidable obstacles, Obama will prevail in the end. Already he's come closer than any of his predecessors. But it's also possible that he'll fail, and if so, there won't be anything unusual about it. Not only has comprehensive health legislation failed many times over the years, but many presidents have failed at many things. George W. Bush couldn't privatize Social Security and his tax-reform legislation sank like a stone. Bill Clinton left office popular and successful, but with few enduring major policy accomplishments. Ronald Reagan cut taxes (using the budget reconciliation process that only required 50 votes) but didn't seriously pare back the welfare state.

Time and again presidents and their supporters learn the main lesson of American policymaking--that for better or for worse, our system makes big changes difficult to implement.

and it is that will either be the death of us and/or lead to more fake vials of yellow cake and dubious intelligence scares in the future

Medicare and Masachusetts Myths

Health economists Amy Finkelstein and Robin McKnight examine what happened when the government introduced Medicare into the market.(PDF)

Abstract: We study the impact of the introduction of one of the major pillars of the social insurance system in the United States: the introduction of Medicare in 1965. Our results suggest that, in its first 10 years, the establishment of universal health insurance for the elderly had no discernible impact on elderly mortality. However, we find a substantial reduction in the elderly’s exposure to out of pocket medical expenditure risk. Specifically, we estimate that the introduction of Medicare was associated with a forty percent decline in out of pocket spending for the top quartile of the out of pocket spending distribution. A stylized expected utility framework suggests that the welfare gains from such reductions in risk exposure alone may be sufficient to cover almost two-fifths of the costs of Medicare. These findings underscore the importance of considering the direct insurance benefits from public health insurance programs, in addition to any indirect benefits from an effect on health.

Massachusetts Health Reform: The Myth of Uncontrollable Costs | Massachusetts Taxpayers Foundation

Despite a public perception that the state's landmark health care reform law has turned out to be unaffordable, a new analysis by the Massachusetts Taxpayers Foundation finds that the cost to taxpayers of achieving near universal coverage has been relatively modest and well within initial projections of how much the state would have to spend to implement reform, in part because many of the newly insured have enrolled in employer-sponsored plans at no public expense.


The Foundation report concludes that state spending on the reform has increased by $350 million between fiscal 2006, the last year before reform, and fiscal 2010 - an average annual increase of only $88 million.


Full Publication (PDF)

Ezra Klein - Americans Hate Everyone, Believe Everything

http://voices.washingtonpost.com/ezra-klein/2009/08/americans_hate_everyone_believ.html
Ezra Klein - Americans Hate Everyone, Believe Everything

It's not so much that the American people have turned against Obama's health-care reform effort as they've turned against the legislative process in general.

*sigh*

Wallace crops VHA doc to falsely suggest Obama administration pressuring vets to end their lives

http://mediamatters.org/print/research/200908230014
from Media Matters for America

SUMMARY: On Fox News Sunday, Chris Wallace repeatedly cropped quotes from a Veterans Health Administration (VHA) document to falsely suggest that the Obama administration is pressuring veterans to end their lives prematurely and to accuse Assistant Secretary of Veterans Affairs Tammy Duckworth of lying about it. In fact, contrary to Wallace's false assertions, the document he referred to does not require doctors to direct veterans to what conservatives have labeled the "Death Book for Veterans."

i guess no one on that channel is redeemable

Health care insurers often dominate market - Health care- msnbc.com

http://www.msnbc.msn.com/id/32524528/ns/health-health_care
of course

WASHINGTON - One of the most widely accepted arguments against a government medical plan for the middle class is that it would quash competition — just what private insurers seem to be doing themselves in many parts of the U.S.

Several studies show that in lots of places, one or two companies dominate the market. Critics say monopolistic conditions drive up premiums paid by employers and individuals.

For Democrats, the answer is a public plan that would compete with private insurers. Republicans see that as a government power grab. President Barack Obama looks to be trapped in the middle of an argument that could sink his effort to overhaul the health care system.

Even lawmakers opposed to a government plan have problems with the growing clout of the big private companies.

"There is a serious problem with the lack of competition among insurers," said Republican Sen. Olympia Snowe of Maine, one of the highest-cost states. "The impact on the consumer is significant."

Wellpoint Inc. accounted for 71 percent of the Maine market, while runner-up Aetna had a 12 percent share, according to a 2008 report by the American Medical Association.

Overhaul supporters tout savings
Proponents of a government plan say it could restore a competitive balance and lead to lower costs. For one thing, it wouldn't have to turn a profit.

A study by the Urban Institute public policy center estimated that a public plan could save taxpayers from $224 billion to $400 billion over 10 years by lowering the cost of proposed subsidies for the uninsured, while preserving private coverage for most people.

"Right now, there's no incentive for insurers or big hospital groups to negotiate with each other, because they can pass higher payments on through premiums," said economist Linda Blumberg, co-author of the report. "A public plan would have the leverage to set lower payment rates and get providers to participate at those rates."

"The private plans would come back to the providers and say, 'If you don't negotiate with me, you're going to be left with only the public plan,'" Blumberg continued. "Suddenly, you have a very strong economic incentive for them to negotiate."

Insurers contend their industry is extremely competitive, and a public plan is unnecessary. About 1,300 carriers operate across the country, although many only have a small share of the market in their states.

"You can have a very competitive market and still have companies with a high market share," said Alissa Fox, a top Washington lobbyist for the Blue Cross Blue Shield Association.

Fox points to the federal employee health program, which also covers members of Congress. It offers a total of more than 260 options and 10 nationwide plans. Despite all the choices, about 60 percent of federal workers pick a Blue Cross plan.

"Insurers need to be of a significant size to best serve their customers and make sure that people get the best value," Fox said.

Nonetheless, lawmakers are concerned. Big insurers are getting bigger. Small businesses in particular have fewer and fewer options for getting coverage.

Congressional investigators this year looked at insurers catering to small employers around the country. The Government Accountability Office found that the median — or midpoint — market share of the largest carrier increased to 47 percent in 2008 from 33 percent in 2002.

The basic framework lawmakers are looking at for a health care overhaul would encourage competition, even without a government plan. It calls for setting up a big insurance purchasing pool called an exchange. It would be open, at least initially, to individuals and small businesses. The government would offer subsidies to make premiums more affordable.

Consumers would find it much easier to shop for a plan through the exchange. For one thing, they would be able to readily compare benefits and premiums in different plans. Also, participating insurers would have to take all applicants and not charge higher premiums to those in poor health.

Offering the option of a public plan would supercharge the competition, supporters say.

Plan could rival giants
Blumberg envisions a plan that pays medical providers more than Medicare, but less than private insurance. Her study estimated it could grow to 47 million members, leaving 161 million with private insurance. Even so, that would make the new public plan one of the largest insurers in the country, rivaling Medicare, Medicaid and big private companies such as Wellpoint and UnitedHealthcare.

It's a scenario that gives pause even to traditional adversaries of the insurance companies.

"The fear and concern is that the public plan could become the market-dominant plan," said Dr. James Rohack, president of the American Medical Association. "When you've got the federal government involved, it can infuse money into a plan to keep it solvent even if the premiums are lower than its actual costs."

Snowe, among the few Republican senators still trying to come up with a bipartisan compromise, wants to hold back on creating a public plan for now and give insurers one last chance to show if they can keep costs in check.

That's doesn't go far enough for liberals, who are loath to give the insurance industry tens of millions of new customers supported by taxpayer subsidies.

"It would give the industry a windfall without any countervailing force to require them to lower their costs," said Richard Kirsch, national campaign manager for the advocacy group Health Care for America Now. "The insurance companies could continue to jack up premiums while getting a whole new market."

one last chance, Snowe? that $1M a day in lobbying fees should have been their last chance

What Value do Health Insurance Companies Bring?

Yet Another Socialized Medicine Win

The Reaction: My brain and the Ontario health-care system

The following was written by a friend and colleague of mine here in Toronto. It is a response to the various right-wing attacks on Canada's, including Ontario's, health-care system -- one in which there is a real "public option," one in which basic government-funded coverage is universal. Supplementary private coverage can be provided through one's employment or otherwise acquired in the market, but there isn't a two- or multi-tier system that divides us based on how much money we have. There is choice -- I selected my family doctor, for example -- but we all go to the same hospitals. At the very least, there is health care for all. And excellent health care, as Paul explains in this very personal piece. I encourage you to read it in full.. (more).

tumor surgery and out to recovery in a week? Took my dad several weeks just to get a biopsy under our wonderful PPO-provided healthcare.

Matt Taibbi's about to lay the smackdown

http://trueslant.com/matttaibbi/2009/08/17/key-feature-of-obama-health-plan-may-be-out-washingtonpost-com/
You remember his earlier piece about the bank bailout that began like this:

It's over — we're officially, royally fucked.

Well now he's coming after the Obama administration and healthcare and why they took single payer off the table to begin with:

Matt Taibbi - Taibblog – Obama’s Pre-emptive Health Care Surrender - True/Slant

Now, obviously (and this is will be explored in more detail in the forthcoming piece, which will be out this week), the public option was not a cure-all. In fact, the Democrats had in reality already managed to kill the public option by watering it down to the point of near-meaninglessness. But the notion that our president not only does not have any use anymore for a public option, but in fact “will be satisfied” if there is merely “choice and competition” in the market is, well, disgusting.

I’ll say this for George Bush: you’d never have caught him frantically negotiating against himself to take the meat out of a signature legislative initiative just because his approval ratings had a bad summer. Can you imagine Bush and Karl Rove allowing themselves to be paraded through Washington on a leash by some dimwit Republican Senator of a state with six people in it the way the Obama White House this summer is allowing Max Baucus (favorite son of the mighty state of Montana) to frog-march them to a one-term presidency?

To quote Method Man’s Calvin “Cheese” Wagstaff character from The Wire, “This is some shameless shit right here.”

it sure is