***OFFICIAL*** Obama's Healthcare summit discussion thread

[werepossum]

My honest suspicion is that some more Republican ideas will be incorporated into a revised Senate bill, it won't be enough to garner any actual Republican support. That is the right solution both from a policy and political perspective.

Sort of the equivalent of six men and four women. We're still going to rape you all, but you're right, there should be wine and music. 😉

 

[Throckmorton]

My honest suspicion is that some more Republican ideas will be incorporated into a revised Senate bill, it won't be enough to garner any actual Republican support. That is the right solution both from a policy and political perspective.

NO amount of Republican ideas would get Republican support. So far they have their exchange, they have their private insurance system, they have the insurance mandate. But they've already committed to demonizing reform as a political tool. That should be clear to everyone, including the P&N Republicans.

 

[Carmen813]

Hey Carmen, can you summarize what's going on? I haven't the heart to read through all this 😀

Well...basically...

But I'm still holding out hope.

What did you think of my idea about vouchers instead of expanding Medicaid?

 

[Throckmorton]

What is this voucher business??

 

[Carmen813]

No, what I'm saying is that leave it up to the states to decide how they want to control the costs. If states, .e.g, California, Oregon, Washington, New York, Massachussetts, decided that it was best to control costs by allowing their residents to buy into a pool from an insurance exchange if they choose to, but required all residents to carry insurance, then they should be allowed to do so. Where as, other states, e.g., Texas, Oklahoma, Nebraska, Virginia, Florida, may choose to let their residents purchase insurance policies that may be located in each other's states, but limited the amount of compensation a victim would receive in a malpractice suit.

I don't know if states can setup compacts like this. I'm fairly certain they can't due to Constitutional reasons...I'm having a flicker of recognition about this being one of the problems with the Articles of Confederation.

 

[Hayabusa Rider]

Well...basically...

But I'm still holding out hope.

What did you think of my idea about vouchers instead of expanding Medicaid?

I was serious when I said I hadn't read the thread. Let me look at your post.

 

[Carmen813]

What is this voucher business??

Just an idea I had.

During the summit they began talking about expanding coverage. It was pointed out that Republicans would expand coverage to 3 million people, Democrats to 31 million people. A Republican pointed out that Democrats did this primarily by expanding Medicaid, which has it's own slew of problems. They also mentioned "welfare."

Obama then said that he wants to fix the problem for people who make just a little bit too much to be on Medicaid, but not enough to buy their own insurance. Basically, people who are working, but just can't afford it.

Obama then asked if Republicans had any other ideas about how to expand coverage. Cue Cricket sounds.

I agree that Medicaid has some fundamental flaws. My solution is to, instead of expanding Medicaid, offer an income scaled voucher system that allows people to purchase insurance on the exchange. It's still "welfare," but it's not just giving more money to a government program. It allows people to slowly build up their own financial independence instead of being tossed off a cliff (which is what happened to me.)

This is a modification of an idea that John McCain had during the campaign. I did not support his idea because it did not contain the other require reforms to bring down costs. Basically, because costs would grow so rapidly, the voucher would slowly become worthless.

Contrary to what a lot of people here have said, the Democrats bill DOES lower premiums according to the CBO. I imagine someone will say that the CBO said it will raise them 10-13%, which is a distortion of what it says.

 

[werepossum]

No, what I'm saying is that leave it up to the states to decide how they want to control the costs. If states, .e.g, California, Oregon, Washington, New York, Massachussetts, decided that it was best to control costs by allowing their residents to buy into a pool from an insurance exchange if they choose to, but required all residents to carry insurance, then they should be allowed to do so. Where as, other states, e.g., Texas, Oklahoma, Nebraska, Virginia, Florida, may choose to let their residents purchase insurance policies that may be located in each other's states, but limited the amount of compensation a victim would receive in a malpractice suit.

That would be a sensible plan; mandate that every state has five years to come up with a plan to cover all its citizens within five years of that date, regardless of pre-existing conditions. That way you have a laboratory with up to fifty systems to compare and if companies or individuals think that a state's system is too punitive or too stingy then they can vote with their feet. That however is not the Democrat way - or apparently the Republican way either.

 

[Carmen813]

I was serious when I said I hadn't read the thread. Let me look at your post.

Haha, I thought you were looking for the smileys again 🙂 I honestly haven't read much of the beginning of the thread.

My attempt at a summary of the discussions currently going on:

Werepossum --> Suspects reconciliation will happen without any real attempt to incorporate Republican ideas. I disagree, because I think its smart policy to include some Republican ideas and smart politics because then during the next campaign they can honestly say they tried. Personally, I'm hoping for some firmer language on tort reform. In general, I think Werepossum is angry with both Republican and Democrat proposals.

Woolfe9999--> We're discussing whether or not the exchanges should have minimum standards in order to be eligible to be listed on the exchange. We're considering one Republican's idea of having a "recommended" label for plans that provide the same coverage as the ones Congressman can choose from (or something like that), but which would also allow any plan (good or bad) to be on the exchange.

Fear No Evil --> Thinks Obama didn't let Republicans speak. I disagree. Still waiting for him to come back.

Cubby123 --> Thinks Obama said the summit didn't accomplish anything. I disagree, and think that perhaps Cubby is being a little disingenuous. I'm trying to be nice about it though 🙂

Throckmorton --> What is Carmen talking about regarding vouchers?

Her209 --> Is asking why not give the states more power to make these decisions? I'm not quite sure I follow her position yet. I think she is saying to allow states to form compacts with each other, but I'm not sure that is Constitutional or allowed by law. I'm a bit confused.

Hope I didn't hurt anyone's feelings. Please correct me if I'm wrong.

 

[classy]

I watched and listened to a good portion of it and its a tough road. Everybody knows and acknowledges that our health care system is in bad shape in a lot of areas. The Dems are trying, albeit in some areas erroneously, but the republicans don't want any success by this President because they want their power. One group, the dems aren't the most trust worthy bunch and the republicans are the most selfish bunch.

But I back Obama. I give him this, no other President has been as ambitous and eager as him to try and truly tackle problems. I would rather have a guy like him, who you may have to throw some brakes on, than a guy like Bush who didn't attempt to do anything. I hope something gets done, because Lord knows we gotta start somewhere.

What I saw mostly was the Dems fighting to back their work on this and the republicans, despite acknowledging the situation, refusing to help in any way. I don't agree with a lot of it, but somebody has to take charge and if the President says he can make it work, then I hope he's right. What I do truly fault the Republicans on is this. This has been going on for a year now, they quote every negative blog and report. They claim its a bad bill, a shady bill, and to expensive of a bill. But yet in a whole damn year, they still don't have a complete and full bill to present.

 

[Hayabusa Rider]

Just an idea I had.

During the summit they began talking about expanding coverage. It was pointed out that Republicans would expand coverage to 3 million people, Democrats to 31 million people. A Republican pointed out that Democrats did this primarily by expanding Medicaid, which has it's own slew of problems. They also mentioned "welfare."

Obama then said that he wants to fix the problem for people who make just a little bit too much to be on Medicaid, but not enough to buy their own insurance. Basically, people who are working, but just can't afford it.

Obama then asked if Republicans had any other ideas about how to expand coverage. Cue Cricket sounds.

I agree that Medicaid has some fundamental flaws. My solution is to, instead of expanding Medicaid, offer an income scaled voucher system that allows people to purchase insurance on the exchange. It's still "welfare," but it's not just giving more money to a government program. It allows people to slowly build up their own financial independence instead of being tossed off a cliff (which is what happened to me.)

This is a modification of an idea that John McCain had during the campaign. I did not support his idea because it did not contain the other require reforms to bring down costs. Basically, because costs would grow so rapidly, the voucher would slowly become worthless.

Contrary to what a lot of people here have said, the Democrats bill DOES lower premiums according to the CBO. I imagine someone will say that the CBO said it will raise them 10-13%, which is a distortion of what it says.

Well a couple things. First, expanding Medicaid will promptly (and literally) bankrupt several states, including our own. Paterson/Albany stole the funds from the lottery, property taxes and the money Obama sent to the states and put most of it on that. Nothing you don't already know.

From what I've read your suggestion is better than what most of the entire Federal government has proposed.

People still don't get the difference between insurance and health care. Go figure.

I'm looking at the expansion of Medicaid, closing the donut hole and other initiatives, and I'm wondering how they are going to pay for this. Costing less? Sorry Carmen, but I remember how cheap Medicare D was going to be. I coughed up half a lung in laughter when I heard what the projected cost would be. It was hilariously underestimated by virtually everyone in government.

Likewise with this. It's going to be horrifically expensive, and the problem of ignorant politicians (who choose to remain that way) crafting all this is spooky.

You have more sense than all of DC, and I'm dead serious. Part of that is due to your first hand experience with the system which you and I have discussed.

They haven't a clue.

 

[werepossum]

I watched and listened to a good portion of it and its a tough road. Everybody knows and acknowledges that our health care system is in bad shape in a lot of areas. The Dems are trying, albeit in some areas erroneously, but the republicans don't want any success by this President because they want their power. One group, the dems aren't the most trust worthy bunch and the republicans are the most selfish bunch.

But I back Obama. I give him this, no other President has been as ambitous and eager as him to try and truly tackle problems. I would rather have a guy like him, who you may have to throw some brakes on, than a guy like Bush who didn't attempt to do anything. I hope something gets done, because Lord knows we gotta start somewhere.

What I saw mostly was the Dems fighting to back their work on this and the republicans, despite acknowledging the situation, refusing to help in any way. I don't agree with a lot of it, but somebody has to take charge and if the President says he can make it work, then I hope he's right. What I do truly fault the Republicans on is this. This has been going on for a year now, they quote every negative blog and report. They claim its a bad bill, a shady bill, and to expensive of a bill. But yet in a whole damn year, they still don't have a complete and full bill to present.

The Pubbies submitted three full health care bills; none made it out of conference. It is disingenuous in the extreme to totally lock out one side - to not allow them in the meetings to create your bills whilst not allowing any of theirs to even be debated or considered - and then accusing them of being the party of "No". Evidently however the Dems think it is good politics.

 

[cubby1223]

Obama says nothing was accomplished at the summit

This is a remarkably ignorant interpretation of what Obama said.

The AP article says that Obama rejects the Republican plan for moving the legislation, that the chances of bipartisan support was basically dead, and that the Dems will likely move forward through the reconciliation process.

To say something was accomplished, I'm curious what you think this summit did. The two sides basically just stated their positions without any give, you know, things that were well established long before this summit began.

 

[classy]

The Pubbies submitted three full health care bills; none made it out of conference. It is disingenuous in the extreme to totally lock out one side - to not allow them in the meetings to create your bills whilst not allowing any of theirs to even be debated or considered - and then accusing them of being the party of "No". Evidently however the Dems think it is good politics.

All the bills written have been available, but I have not seen one bill written by the republicans? Do you have a link to one?

 

[Craig234]

I thought it was nolt very impressive for most of the participants. It was not at all at the level such a topic deserves.

I can't remember the last time a President did something like this. It did help show how the attitudes are.

The Republicans seemed to have planned to each say they want to start over

One disappointing exchange was when John McCaion disengneulousy tried to pretend that reconciliation is the 'nuclear option' and trumpeted his role in having prevented that.

Obama didn't correct him, that reconciliation and the nuclear option are totally different, reconciliation being a Senate rule reportedly used 22 times since Reagan took office, 16 of the 22 by Republicans, including both Bush borrowed tax cuts. The nuclear option was a threat created by Republicans to prevent the filibuster, where they identified a maneuver to declare the filibuster itself unconstitutional forever.

Obama seems fixated on not exercising his power to get something done, like a parent who only makes decision with the permission of the child, who isn't about to give it.

By all the soft approach, it seems Obama has painted himself into a corner, to either give far too many concessions to Republicans, or to get it done without them and get attacked for ignoring them.

 

[werepossum]

Well a couple things. First, expanding Medicaid will promptly (and literally) bankrupt several states, including our own. Paterson/Albany stole the funds from the lottery, property taxes and the money Obama sent to the states and put most of it on that. Nothing you don't already know.

From what I've read your suggestion is better than what most of the entire Federal government has proposed.

People still don't get the difference between insurance and health care. Go figure.

I'm looking at the expansion of Medicaid, closing the donut hole and other initiatives, and I'm wondering how they are going to pay for this. Costing less? Sorry Carmen, but I remember how cheap Medicare D was going to be. I coughed up half a lung in laughter when I heard what the projected cost would be. It was hilariously underestimated by virtually everyone in government.

Likewise with this. It's going to be horrifically expensive, and the problem of ignorant politicians (who choose to remain that way) crafting all this is spooky.

You have more sense than all of DC, and I'm dead serious. Part of that is due to your first hand experience with the system which you and I have discussed.

They haven't a clue.

The Heritage Foundation tore a hole in the CBO's cost assessment of the Obama plan for its incredibly rosy economic predictions. This is a common problem in Washington, as the CBO scores plans according to its predictions. I see no way though to make a more non-partisan scoring agency; if the CBO makes adjustments, then those adjustments must be made with a positive or negative assessment that just invites partisanship.

 

[classy]

The AP article says that Obama rejects the Republican plan for moving the legislation, that the chances of bipartisan support was basically dead, and that the Dems will likely move forward through the reconciliation process.

To say something was accomplished, I'm curious what you think this summit did. The two sides basically just stated their positions without any give, you know, things that were well established long before this summit began.

You're right. Nothing changed. My hope is that he drafts a bill with all the measures that don't cost a dime. And I bet my bottom dollar, the republicans still won't support it.

 

[Craig234]

Why didn't allowing negotiation of drug prices in Medicare come up once that I saw, much less come up in the last year of hearings and plans?

 

[Carmen813]

Well, one of the big changes Obama proposed was 100% federal funding of the Medicaid expansion for every state. So the good news is it won't bankrupt the states, just the federal government.

That's part of why I think the voucher idea is better, but it's still not ideal. I could see it creating a similar problem to that which exists with education and federal grants (which, while making costs most affordable to some, probably drive up costs also).

I think Tom Coburn made many excellent points regarding the importance of making costs more transparent to patients. He basically said costs will continue to spiral until people stop asking "will my insurance cover it?" and instead recognize that they don't need an MRI for a sore knee.

The Republicans made a pretty good argument that the Medicare cuts should be put into Medicare benefits or deficit reduction. To that end, that is supposed to be the aim of ending Medicare part C. Obama said they should take the $180 billion going to insurance providers, and instead use it to close the donut hole. Republicans said they should just use it to help keep Medicare alive.

 

[classy]

The Heritage Foundation tore a hole in the CBO's cost assessment of the Obama plan for its incredibly rosy economic predictions. This is a common problem in Washington, as the CBO scores plans according to its predictions. I see no way though to make a more non-partisan scoring agency; if the CBO makes adjustments, then those adjustments must be made with a positive or negative assessment that just invites partisanship.

No offense, that is partisan bullshit. The CBO has a solid history of being non-partisan and judging things solely on facts.

 

[Hayabusa Rider]

Why didn't allowing negotiation of drug prices in Medicare come up once that I saw, much less come up in the last year of hearings and plans?

Because traditionally cutting costs means cutting reimbursements. It's often below the amount needed to provide care. It's easier to club the provider than antagonize contributors to war chests.

No one wants that, although limiting what providers pay would allow them to apply more resources to patient care AND save some money.

Never happen.

 

[Hayabusa Rider]

No offense, that is partisan bullshit. The CBO has a solid history of being non-partisan and judging things solely on facts.

Non partisan does not mean correct. They simply are out of their depth along with Obama and Congress when it comes to health care. I cite Medicare D as proof.

 

[classy]

Why didn't allowing negotiation of drug prices in Medicare come up once that I saw, much less come up in the last year of hearings and plans?

It did come up briefly. Obama mentioned it in his response to how to bring down costs, which was to allow cheaper drugs from Canada. I forget all the particulars surrounding the exchange, but it did come up brielfy.

 

[Carmen813]

The AP article says that Obama rejects the Republican plan for moving the legislation, that the chances of bipartisan support was basically dead, and that the Dems will likely move forward through the reconciliation process.

To say something was accomplished, I'm curious what you think this summit did. The two sides basically just stated their positions without any give, you know, things that were well established long before this summit began.

The Republicans want to totally scrap the current bills and start over. It's nothing more than a delaying tactic. It's also a red herring, you can make infinite changes to the existing bills and have them re-voted on. That's what the purpose of reconciling bills (*note* I'm not talking about the Senate parliamentarian tactic of reconciliation, but rather the melding of the House and Senate bills)is. I believe that they have little desire to actually reform health care in significant ways.

As for what was accomplished, I personally think bringing together the leaders on this issue and having a six hour televised discussion is a good thing. I wasn't expecting miracles. I think it highlighted to many people (if they watched) how much broad agreement there is on the general issues, it's the details that there is some contention on.

Finally, it showed to the American people that you can disagree without being disagreeable. Given the despicable displays I saw over the summer, and routinely see on this forum, I think that is a MASSIVE accomplishment. Yes, there were times when the discussion was heated, but by and large it was respectful and civil. The country needs to have this debate in a respectful manner.

 

[classy]

Non partisan does not mean correct. They simply are out of their depth along with Obama and Congress when it comes to health care. I cite Medicare D as proof.

See thats the problem. The Republicans quoted the CBO when they spoke negativley of earlier healthcare plans. But now they are suspect because they speak favorably of the latest plan. Here are the republican responses. Its No. Or if they support our position, lets quote them. Or if they don't support our position, lets say they are untrustworthy and in bed with Obama. Its such a joke.