Paul Krugman’s column about how President Barack Obama has lost the trust of progressives is justifiably being widely noted this morning. Definitely worth a read if you have a moment to click through.
It’s hard to avoid the sense that Mr. Obama has wasted months trying to appease people who can’t be appeased, and who take every concession as a sign that he can be rolled.
As Krugman notes, the coddling of the financial industry and hanging progressives (and many members of Congress, it should be noted) out to dry this August have created a very bad situation. As always seems to happen, Democrats will take your money, your time and your energy, and then sit down and give everything away before any real bargaining has even taken place.
It seems to be some kind of congenital disease in the party. The only thing saving Obama right now is House progressives, who are refusing to be taken hostage by the petty clown shows around the country.
Now, there is a lot to be said for party unity and being team players. But the players need confidence that the coaches aren’t secretly making deals with the other team (cough Billy Tauzin cough,) or they won’t play hard, if at all.
You can’t negotiate with lying asshole scumbags whose only goal is to ratfuck you, this is pretty basic stuff. And all across this land, the lying scumbag Republicans are busy ratfucking. You have to admit, it’s a skill they learned long ago, and from Nixon’s time to ours, it’s the one consistent thing about them. If only ratfucking cured people, we’d be in Paradise.
And while I don’t usually begrudge politicians some well earned rest and relaxation, the president going on vacation now when millions of Americans are taking “staycations” is incredibly tone deaf. Sorry, but politics isn’t always fair, and the righties are going to do everything they can to exploit it. Send the wife and kids, and get back to the White House or go out to some districts and help some of these Congress-critters.
Facts don’t matter in America any more, so I’m not down with the counter- argument that Bush took 80 gazillion days of vacation, nobody cares. We’re in a post-reality twilight where it’s okay to bring guns to political events and spread lies about how health care reform would be just like Nazi euthanasia programs and otherwise behave like uncivilized fools. The traditional media tends to lap it up like dogs, never noticing that the ones actually holding the needle are eyeing them as well, with a gleam in their eye. If the lunatics take over the pound, the dogs will be the first to go.
And yes, please tell me how awful it would be if Republicans win big in 2010 or 2012, I know, I know. We might wind up with two quagmires abroad, a massive deficit, a hollowed out manufacturing sector, a financial system that amounts to a kleptocracy, no gains in civil rights for gays, or of all things, no meaningful health care reform.
That would be terrible.
As Bob Dylan (the real one) used to sing, “How does it feel?”
You can’t have bipartisanship if there are deep seated mutually exclusive bedrock assumptions. The last truly ‘bipartisan’ moment this nation had was getting into WWII and winning that fight.
Since then, not so much.
I suggest that Jon and other obligate libruls temper their fires.
It might be fun if Obama were to play wargames, a side to side fusillade makes great movies.
BUT, he is a practical guy. If the result of all this is an economy that makes it and we get a process in place (as he said during the campaign) that makes reform possible.
What is the alternative? If BHO starts decrying the birthers and deathers, what will that accomplish?
Single payer? Even leaving the politics aside, the administrative challenges are pretty hard to imagine. How does a single payer system deal with our current mix of providers??? Are you prepared to close Swedish?
I too would like my hero to thrust out his chin and call out the dumbasses … but I suspect he is a lot smarter than I am!
LBJ screwed the pooch on ‘Nam, both fighting it and how to pay for it, but Obama could use a few lessons on playing LBJ style hardball.
Looks like somebody doesn’t like Republicans.
I think Obama did the right thing initially by trying to play with the Republicans. After all, they do represent over 40% of the nation’s voters. But, congressional Republicans have clearly now showed their bad faith; in spades, they have demonstrated that they care far more for partisan advantage than for the nation’s best interests. So, Obama should simply ignore Republicans now on the healthcare issue. He needs to just shore up Democratic support, then walk over the Republican corpses.
re 2: “Single payer? Even leaving the politics aside, the administrative challenges are pretty hard to imagine. How does a single payer system deal with our current mix of providers??? Are you prepared to close Swedish?”
Do you think that there would be mass confusion if there were only one insurance provider? Would people’s mind’s be boggled?
Do you have several health plans for yourself to avoid this sort of confusion?
Each insurance provider is an entity unto itself and deals with multple health providers.
Are ye not so much more than they??
I read the Krugman op/ed. At the bottom it says: “David Brooks is off today.” My first thought was ‘Thank God!’ A day without having to see, hear, or read that sniveling little rodent’s opinions is a day that is blessed indeed.
re 5: That’s assuming that Obama is not the playground sissy he’s been presenting himself to be.
He has to prove now that he’s got what it takes to win this fight. People pleasers like Obama work ever so xtra hard to get people that don’t and won’t like them to be their friends and piss on the ones who already are his friends.
@5
Yep! But, when they failed to work with him and started to scream all sorts of nonsense he should have walked away.
@2 There are plenty of other countries with a single payer but multiple providers. I was just reading a posting elswhere this morning by a Dane, whose wife is a US citizen and who spends time both here and there. People there can choose their primary-care doctor, who refers them to specialists as required. There’s also a provision that if where you’re referred to for specialized care can’t deal with you in short order, you’re quickly referred somewhere else. As is the case in Canada, it’s perfectly OK to purchase supplemental private insurance, and some do–mostly to cover things like cosmetic surgery.
One interesting thing this guy pointed out, is that in Denmark they try to encourage people to see their doctor more often, to make sure problems are caught and dealt with before they become more serious. By comparison, a relative of his wife here in the US put off going to the doctor with a leg abcess because he was afraid his insurance wouldn’t pay for the visit. As a result, he ended up losing his leg.
[Deleted — see HA Comment Policy]
[This may help — Darryl]
HNMT @ 11
Seems like you’re making a great argument for VA Health Care for all..
or the Brit system…
I’m sure you tried your best.
Little brother: Hope you got down to the part about Brit health-care costs increasing even faster than ours. Realize, tho, that you’re a slow reader and that Darryl is a fast fascist fact fucker who can’t handle the truth when he’s power trippin’. Why bother with inconvenient truths when you can just whack ’em with the delete macro?
As for the VA, it’s emphatically part of the single-payer pathology. Did grad econ analysis on a VA Med Center my very own self.
Now, I don’t want pre-Nixon ratfuckers to feel slighted.
To be absolutely fair, conservatives were ratfuckers in 1917 when they opposed universal health care. They were ratfuckers in 1933 when they opposed Social Security. They were ratfuckers in 1949 when they opposed universal health care. And they were ratfuckers in 1965 when they opposed Medicare (and the Civil Rights Actand Voting Rights Act, for that matter). Which makes Saint Ronald Reagan a ratfucker too. But you knew that.
2 SJS
Yes, surely Medicare is impossible!
13 berlin
Maybe you do not understand the difference between “rate of increase” and “amount of increase” but we do. Britain spends about of what we do per capita for health care. Their rate of increase may be a higher percentage of their smaller amount, but that may not be very comparable (you do not even try), and may not be long-term.
They British right now have some cost-control challenges, and so the the French. And so do we. So what we’re doing about it right now is passing a comprehensive health insurance reform bill. The proposed bills have a variety of cost control measures. If you want to discuss any one of them, I for one would be glad to.
One of these cost-control measures is to offer a publicly funded health insurance plan in whic participation is optional. If Americans think that a cheaper plan that offers robust coverage is better than the dreck that today’s insurers offer, then the private insurers are going to have to reduce prices, offer more and better services, or both. Et Voila! Costs are more controlled than they were.
@16 Admittedly, one possible solution would be to redefine “reform” to mean something other than half a century or more of the right’s yammering about “getting government off the backs of business”…and instead work to get business off the backs of the people. I don’t think I’d have a problem with letting private business provision health care if they were forced to do a better job of it. The other half of the bargain would be to have government help the insurers take care of those in such dire straits that they’re looking at a choice between health coverage and other necessities. Then I’d seek to re-regulate the way Wall St. and a bunch of other industries do their jobs, to break the corrosive boom-and-bust cycles that inevitably reduce people to desperation absent any fault of their own.
re 16: That must be how that ‘competition’ thing works. The Republican idea is that you are free to set up ‘Daddy Love’s Health Insurance’.
No financial backing?? — well —that’s the way the cookie crumbles in Republiworld.
Quityerbitching! Obamacrats have a filibuster proof majority in both houses of Congress. Republicans are content to give all the blame, er-credit, to the Dems for destroying Medicare and the private medical system.
Saw the former head of the Canadian Medical Association on TV last night. He says the Canadian system is fucked.
Inslee’s committee rejected a healthcare amendment that would have allowed verification of citizenship status to receive Obamacare. Now were gonna have to fork over the dough to subsidize 15-20 million fuckin’ illegals who have never had healthcare. Who knows what the hell they’ll need. Obama points to the USPS to show how government fares against private carriers like FedEx and UPS.What a shithead! That gives us all an indication as to what we can expect from a wholly-owned federal program.
John425,
“Quityerbitching!”
Why? Don’t I have a right to bitch?
“Obamacrats have a filibuster proof majority in both houses of Congress.”
Ummmmmm…no. There is no such thing as a “filibuster proof majority” in the House.
In the other Chamber of Congress, there has not been 60 Democrats present owning to one Senator who is incapacitated by brain cancer, another who had a protracted hospitalization, and a third whose close election underwent prolonged adjudication.
“Republicans are content to give all the blame, er-credit, to the Dems for destroying Medicare and the private medical system.”
This is incorrect. They are actively opposing it. In part this comes by inventing factually untrue talking points. You know, “Government Takeover”, “Death Panels”, etc.
“Saw the former head of the Canadian Medical Association on TV last night. He says the Canadian system is fucked.”
If you believe that, then I would advise you to not move to Canada.
“Inslee’s committee rejected a healthcare amendment that would have allowed verification of citizenship status to receive Obamacare.”
Good for him and that committee!
“Now were gonna have to fork over the dough to subsidize 15-20 million fuckin’ illegals who have never had healthcare.”
WTF?!? First, many “illegals” get health care just like you and I do. Health insurance reform would give them more choices for health insurance just like it will for you and me.
Secondly, for uninsured “illegals”, you most certainly do subsidize them, dumbass. You just don’t realize it.
“Who knows what the hell they’ll need.”
Probably the same kinds of things you will need.
“Obama points to the USPS to show how government fares against private carriers like FedEx and UPS.”
Oddly enough, FedEx and UPS make a profit even competing against a government alternative. Odd, that.
“What a shithead!”
LOL! You scarcely have a grasp on the issues and he is the “shithead!” (*snicker*)
“That gives us all an indication as to what we can expect from a wholly-owned federal program.”
Indeed…it makes Obama’s point that a non-profit government-run choice in health insurance won’t drive the for-profits out of business.
Got any more
hate-talk radio talking points“bright ideas” to share with us, Wingding?“In part this comes by inventing factually untrue talking points.”
That’s quite an elegant, polite and undeserved euphemism for “being a damned liar”.
Art didn’t like our deconstruction of the 46 MILLION UNINSURED “fact”oid. Of course he couldn’t dispute the analysis showing that the big scary number is a product of leftist noise machine Big Media spin, so maybe he had a nervous breakdown, his 19th, while listening to NPR’s Morning Sedition this morning.
NPR Big Media started breaking down the number. ~20% of the 46 million Americans aren’t Americans. They’re illegal immigrants.
~25% of the 46 million are currently eligible for enrollment in existing programs such as Medicaid.
And NPR didn’t even attempt to determine how many millions of the 46 million uninsured can afford to buy insurance, but choose to refuse.
@14
St. Ronnie sold his own people down the river while supporting McCarthyism.
Darryl and his brother, Darryl: What a twit. You just can’t go one being an apologist for ever.
To quote Dean Vernon Wormer: ” Fat, drunk and stupid is no way to go through life, son.”
John425,
“Darryl and his brother, Darryl: What a twit. You just can’t go one being an apologist for ever.”
LOL! I can’t really make heads or tails out of this, but I think you are saying “Uncle!”
re 24: For most of us, Dean Wormer was not the protagonist.
1917: The Sedition and Espionage Acts, supported by some conservatives, were approved overwhelmingly by progressives since they were enacted by progressives. Then they were used to mete out sentences of 10-20 years for those who voiced opposition to Woodrow Wilson or Woodrow Wilson’s war. Then they were used to arrest and deport, without trial, hundreds or thousands of citizens and noncitizen immigrants. A foremost opponent of Wilson fascism was a Republican judge in Montana.
1933: There was no social security in 1933. Much legislation of 1933’s Hundred Days was supported by Republicans in Congress. Some supported Social Security in 1935.
1949: Truman had Democrat majorities in Congress in 1949. Democrats in Congress shot down universal health care.
1965: A greater proportion/percentage of Republicans in Congress, than Dems in Congress, voted for the Civil Rights Acts. Makes sense since the first civil rights acts after Reconstruction came from Republicans in 1958 and 1960. (Republican Harding couldn’t overcome Democratfuckers to get an anti-lynching law. Democratfucker FDR didn’t even try to get an antilynching law.)
etc etc etc etc etc.
Daddy Love says:
Britain spends about of what we do per capita for health care.
DL: I usually agree with most of your positions, but I take issue with this. First, most comparisons are based on GDP. I have provided the link to percent of GDP expenditures and we spend 15.3% of our GDP on health care. That is close to double what any other industrialized country spends.
http://scienceblogs.com/effect.....h_care.php
For comparison, the UK spends 8.4%, Canada 10% and Japan 8.1%.
National health spending is expected to reach $2.5 trillion in 2009, accounting for 17.6 percent of the gross domestic product (GDP). By 2018, national health care expenditures are expected to reach $4.4 trillion—more than double 2007 spending.
Medicare is impossible, Dad. Been trying to tell you, but Darryl can’t deal with it.
Finally found a per capita source and it is even worse than the GDP data:
2005 data:
US – $6401
UK – $2724
Canada – $3326
Link: http://globalhealthnet.com/Per.....pense.html
So the idea or the half-baked argument that UK costs are increasing at a greater percentage than US costs…so WHAT!
the costs start off at less than 1/2 of our costs….they could increase by 100% and still not catch up to us.
this is a total straw man argument.
1917: What derailed Meyer London’s socialist health care wasn’t Republican opposition. It was progressive Democratfucking from a tyrant regime (Wilson’s) that promised to keep us out of war and then pulled us into war.
Meyer made his move in February. Woodrow made his about two months later. Checkmate. Woodrow lied (about our neutrality, etc.) and universal health care died.
So did democracy. Took ten Republican years to get it back.
Links, awaiting moderation:
NPR Morning Edition, today, re 46 million uninsurted.
My slow Daddy (so slow it takes him 1 1/2 hours to watch 60 minutes) thinks I don’t the difference between rate of increase and amount of increase. But the point of Goldhill’s very long article is that the rates and amounts of increase of Brit single payer and of our Medicare distorted care are unsustainable.
Maybe Daddy would and could have understood Goldhill’s point if Darryl the liberal fascist hadn’t chopped Goldhill. But Darryl did, because that’s what Darryl does. That’s what he’s good at. G*d knows he’s not good at algorithms.
@27: Lie much?
Complete idiot, revisionist historian and lying fool says:
Umm, 16 out of 25 supported it at the time….but by 1937, when it was about to be enacted one of Presidential candidate’s Alf Landons major platform goals was the elimination of SS:
http://www.dissentmagazine.org.....rticle=234
Republican obstructionism has been around for a long time. You can run but you can’t hide from the truth.
@ 6. headless: Rat City Runcible Spoon
The issues with single payer are not just that you or I or any consumer might find it confusing.
The real,problem is that we have such a cacophony of VERY different health care providers that a single payer would have also involve changing these as well. Regional differences in how much is pai9d for healthcare are huge. Within any one place, institutional models for how healthcare is charged for .. and the resulting cash flows, are also huge.
Here in Seattle, we range from providers of very expensive “concierge” medicine, to a successful health coop, to fully government provided care, to alternative health models.
For single payer to work there would need to be some standard and any standard would alter how some of these providers work.
ctd.
ctd.
on the consumer side there are other probelms with single payer.
The US is unique in that most of our health care is aprt of our work agreements. A single payer system would necessitate renegotiating virtually every union contract and labor agreement in the country.
In contrast, a government option, allows a single payer model to develop. So next time your employer writes a contract you and BigBoss can decide between benefits t your 401k or continuing a Primera Healthcare policy.
@29 Right. And the Earth is flat, and the moon shots were faked.
@10 ArtFrat
Sure and I think we will evolve to something like the Danmish/Canadian/French system.
The problem is how YOU define “single payer.” Single payer with the option for additional insurance is basically Medicare for all. BUT, Medicare now works by cost shifting to private insurance. Hospitals that can not make enough money from Medicare make it up by shifting costs to other income sources.
If everyone were on Medicare cost shifting would not be possible. That is, in my opinion, a good goal, but in the meantime we would need to deal with existing institutions that can be quite valuable that would not survive.
I am also not convinced that there is not a place, as you say, for private insurance as long as we have a common floor to start from.
@15 Daddy
National, universal Medicare is not feasible.
Medicare NOW is not truly national as tyhere are huge variations in how much is paid for the same thing across the country.
Nor is it truly universal because it creates cost shifting.
SJ says single payer is not feasible….so it must not be….because…well, the current system is not feasible…check out the costs! Check out the failure to cover people (1/3 of all people under 65), check out the lack of preventative care and the overall health statistics (on par with Slovenia after spending almost double of every other civilized country)…..Could we do worse than what we have now is the better question to ask?
Probably NOT!
@38 correct not right
Please do not misquote me.
I said single payer is not feasible NOW because our system has too many problems for a quick fix and the administrative challenge of moving from where we are now to a single payer system is beyond the competence of government.
Imagine making a single payer work:
1. what would happen to labor contracts based on employer funded insurance?
2, what would happen to naturopathic clinics?
3. what would happen to systems dependent on the excess money .. Swedish or Cleveland Clinic?
About the only way we could get to single payer in a single bound is by nationalizing the existing system and that would be a nightmare.
The virtue of a public option, even one called a national coop, is that provides tool .. a way to cushion the changes that need to occur if we are not going to collapse.
SJ — Single payer would reimburse healthcare providers in the same way that Medicare does. They would not have to do all the replication that you think they would.
As I recall, you have some skin in this game of private over public.
Sounds to me like you are regurgitating someone’s talking points.
@40 Headless
I am a state employee and a UW prof. I nget my insurance form a WA state government version of the plan proposed by BHO. It is called Uniform and it runs in the black.
Suince noone has actually proposed a concrete version of single payer, you have no way of knowing what it would actually look like, However, it can not simply be a an extension of Medicare for reasons I already stated.
1. Medicare does not now have a national payment schedule. Payments at the rate allowed in Seattle would likely bankrupt hosptials in other areas of the country.
2. Medicare’s payment shedules only work because of an indirect tax. Medicare does NOT pay its full way. Instead costs are shifted to other payers who would no longer exist under single payer.
The advantage of public option OVER single payer is that it offers a tool to reconfigure ou8r system by creating a national standard that is self financing and fully accounted for without requiring a draconic cyhange in the current system.
Does this make sense?
Persoanlly, FWIW, I prefer single payer a la the French system. To get there from here, however, we have a lot of work to do. Two specirfic issues that concern me:
1. we need to lower the3 cost of training,. As long as we make med studs take out loans of 100,000s of $$, we can not fix our system.
2. Currently the US SUBSIDIZES the world by our overpaying for drugs. We ne3ed to try to find a way to continue the drive for discovery but doing so in ways that will make the costs of that effort more equitable.
3. In the same vein, even though the US taxpayer and drug payer is the major supporter of health research FOR THE WORLD, we do not keep the profits from the drug companies here. We need to do a lot more to develop laws for IP so that American investments are productive of jobs and capital here.
Yeah, I’m against appeasement! Chamberlain should have bombed Berlin in 1938; and when healthbaggers show up at presidential speeches packing heat the Secret Service should drill ’em without further ado!*
* Just kidding! Ann Coulter death joke. The part after the semicolon (;), I mean; I think everyone agrees the Brits and Frenchies shouldn’t have waited for Hitler to invade Poland before declaring war.
re 41: You know, to mow the lawn, you do not need to know everything about the lawnmower. In fact, you would be stymied if you thought that you did.
Many a difficult yet worthwhile journey has begun sinply by making the decision to do it. What would Moses have done if he had thought of the logistics of the journey he was embarking on?
People like you are the Boo-Boo Bears of the insurance reform movement. Personally, I don’t care if Mr. Ranger gets angry.
@43 Headless
ahhhhh ….
so you would hope that the Deity would rain manna from heaven and flood the bad guys to make heathcare work?
Personally, I would like to think of Colin Powell’s sort of strategy of actually planning a war before going into it, but maybe you are channeling George Bush?
Tom Tomorrow agrees with Krugman.
Richard L. Scott, a former Swift Boater suspected of orchestrating the GOP’s health care disruption tactics, doesn’t believe government should help people but he sure believes in stealing from government. His hospital company paid millions of dollars in fines and over $1.7 billion of civil penalties for Medicare fraud.
I’ll bet it gives the healthbaggers a warm glow inside to know they’re marching to the drummer of the nation’s most prolific Medicare thief.
re 44: You worry too much. They’ve actually got you believing that this krazy kwilt system we’ve got will be hard to change.
The costs will just be standardized — as I’m sure most of them already are. You know, with Medicaid and Medicare, we have some experience with this.
The point about Manna and floods is that you can’t foresee everything. Quit being such a bummer. You are kind of a hand-wringer — like George Costanza’s Dad.
re 44: You’re causing me a lot of AGGRAVATION!!!
@47 .. I suppose I am a hand wringer.
Eric Alterman has a more nuanced view.
There’s a point to be brought up that about 40 years ago, there was much discussion of “portable plans” for retirement and medical care. We sorta-kinda took care of #1 with IRA’s and 401(k)’s…at least until the Wall Street shysters took Mom and Pop’s nest egg and blew it on “investments” that were dicier than a back-alley crap game.
As to “portability” of health coverage…at one point the assumption was that this would be handled by unions and professional societies like the IEEE, ACS, Bar Association and their ilk. To a degree these organizations ended up dropping the ball, but the greater influence has been an ever-declining percentage of the work force belonging to unions or professional organizations.
At one time, some of this was caused by what could be viewed as corporate altruism. Nobody saw a need to join such an organization if they worked for a company like IBM or any of its descendents, which certainly wanted to keep the unions away but also made it a matter of pride to “take care of their people”–the medical plan provided gratis by Intergraph when I worked for them was the most comprehensive I’ve ever seen.
Of course, back in the day many such organizations had openly stated no-layoff policies. If a CEO tried something like that now, the Wall St. shysters would be calling for his public disemnbowelment.
@43 “Payments at the rate allowed in Seattle would likely bankrupt hosptials in other areas of the country.”
Are you claiming that Seattle hospitals and providers are that much more efficient, or what?
@54 AF
I wish I understood the ways costs are calculated in healthcare but it is a fact that there are huge differences in costs from region to region. Nothing I have seen explains ths very well.
I don’t know if there’s anything more useless in the business world than an economist. Krugman is a classic example: the guy must have received his economics training at Wal-Mart.
The second most useless group in the business world is bankers. All they have to do is loan money to people and companies that can repay the loans and they’re good to go. Yet the bankers even screw up THAT simple task!