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Aug. 20 2009 - 6:40 am | 189 views | 13 recommendations | 73 comments

Health Care Rats Come Out Of The Woodwork

It is not the be-all and end-all of health-care reform. It is not the long-awaited safety net for the uninsured. And if, as many liberals hope, it turns out to be nothing more than Medicare for All, it won’t do anything to hold down long-term growth in health spending.

via Public Optioned-Out – The Opinionator Blog – NYTimes.com.

There are some days when it almost seems like the national press is making a conscious effort to prove Noam Chomsky’s Manufacturing Consent gospel. If the national commercial media really did exist solely to perpetuate the attitudes of the political elite, and to create phony debates around unthreatening policy poles, endlessly pitting a conservative/reactionary status quo against an “acceptable” position of dissent — if that thesis were the absolute truth, then you’d see just what we’re seeing now in the coverage of the health care debate.

All across the country the news media reacted to the White House leak about the possibility of the public option being dropped with, well, an oddly circumspect tone. Although some initial stories carried a sensational tone, within a day or two the debate had settled down, and the country’s most prominent pundits were considering this treacherous and cowardly development in a pragmatic light. In Eric Etheridge’s review-of-reviewers blog in the Times, the “Opinionator,” the situation was described this way:

The debate is primarily on the left, or among the Democrats, where partisans are furiously arguing along two intersecting fronts: First, the public option is or is not an essential element of reform. Second, abandoning the public option will or will not make passing the remainder of reform more likely.

This superficially is true, I guess. There were a few voices arguing that the public option is the bare minimum “reform” that the public should tolerate, and a few who argued that if it is not in the final version, progressives should reject the proposal.

But overwhelmingly the pundits went the route predicted by Manufacturing Consent. The most prominent voices in the last two days have mostly chosen one of two sides to argue. Many attacked the public uproar over the White House’s apparent surrender, blasting the public option as an unrealistic and meaningless affectation, a policy kewpie doll for unrealistic liberals who “don’t want to be bothered with the real-life dynamics of the health care market,” as the Washington Post’s Steven Pearlstein put it (in his column with the amusingly obnoxious title, “Enough Already With the Public Option!”). The White House itself is covertly putting itself in this camp via “unnamed” sources who are expressing rank insider astonishment over the rabble’s naivete, for instance here in the Washington Post:

“I don’t understand why the left of the left has decided that this is their Waterloo,” said a senior White House adviser, who spoke on the condition of anonymity. “We’ve gotten to this point where health care on the left is determined by the breadth of the public option. I don’t understand how that has become the measure of whether what we achieve is health-care reform.”

“It’s a mystifying thing,” he added. “We’re forgetting why we are in this.”

Where the chief executive of any administration is on almost any issue, one can also usually find Hobbit understudy and professional White House apologist Joe Klein. Here he is on health care, licking as usual the presidential jellyring:

Meanwhile, I never had much interest in a public option. I think the perils of government-delivered (as opposed to funded) services are obvious and immense. Sarah Lyall had an excellent piece in the Times today about her dealings with the British National Health System, which has some very real strengths, but also some terrifying weaknesses…. I spent the weekend traveling through the west with the President, watching him perform at health care forums in Montana and Colorado. He did quite well, I thought.

So that’s that camp. Then, on the other side, there was a whole rash of others who took the pragmatic, chin-scratching route, embracing in advance the possibilities of a public-option-less health care reform. A lot of the people making this argument seemed to have good intentions. One example was Matthew Yglesias:

A set of consumer protections that would cap out-of-pocket health costs, guarantee access to preventive care, and prevent insurers from treating people well as long as they’re healthy only to start monkeying around when they get sick. This would be a big deal. The bills in Congress also envision expanding the Medicaid program that currently serves the poor. This would only help a relatively narrow slice of the near-poor, but for those who are helped, the help would be enormous.

And Kevin Drum at Mother Jones:

So as much as I’d like to have a public option (primarily for its ability to force more robust price competition), I just don’t see it as something to threaten nuclear destruction over.  If insurance reforms are robust and low-income subsidies are decent, that’s a huge win for millions of people, and it’s a win we can build on.  And contra Atrios, social legislation does have a history of getting better after it’s first passed.  Just ask Henry Waxman.

Then there was Nate Silver:

The fundamental accomplishments of a public option-less bill would be to (1) ensure that no American could be denied coverage because of a pre-existing condition or because they became sick; (2) subsidize health insurance coverage for millions of poor and middle-class Americans.

These are major, major accomplishments. Arguably, they are accomplished at too great a cost. But let’s look at it like this. The CBO estimates that the public option would save about $150 billion over the next ten years — that’s roughly $1,100 for every taxpayer. I’m certainly not thrilled to have to pay an additional $1,100 in taxes because some Blue Dog Democrats want to placate their friends in the insurance industry. But I think the good in this health care bill — the move toward universal-ish coverage, the cost-control provisions — is worth a heck of a lot more than $1,100.

So this is where the “debate” is being framed. One side argues that the public option isn’t anything to write home about. The other “side” argues that a bill without the public option won’t be a disaster after all. Of course if you’re paying attention these are both actually the same argument, arguing the same side.

I get that the public option isn’t a cure-all and I also get that it would be nice if they passed a law preventing insurers from denying patients with pre-existing conditions. But what strikes me the most is how the instant the public decides it’s fed up and really wants something, all these arguments suddenly appear in the press showing why they are unreasonable and uneducated and should take a more “nuanced” (God, I hate that word) view of things. It seems to me that if you pay careful enough attention to the underlying theme of a lot of these articles, the pundits’ biggest concern about the public option is that their readers are demanding it in spite of what they are being told. Me personally, I think the time to consider what good stuff might be in a public-option-less bill is after you’ve lost that battle, not before.


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  1. collapse expand

    As an outside observer, the current debate, the msm’s portrayal of it and the democrat’s complete lack of assertiveness is truly surreal. Frank Zappa once said that the most common element in the universe isn’t hydrogen, but rather ’stupidity’, and watching this debate makes me wonder if I haven’t found the very center of it.
    The failure of health care reform in the United States will soon read like an Oscar acceptance speech with “so many people to thank.” The left/progressives don’t understand that sometimes you just gotta do something and hope that in the future you’ll be seen as either right, or at least decisive when something had to be done.

  2. collapse expand

    Today’s healthcare debate is meaningless. The future of healthcare is coming irrespective of which group of Baby Boomer politicians win sway in the media. That future is very simple: there are two Boomers for every member of Generation X. They will bankrupt the current system as they beginning demanding care for record levels of diabetes, heart failure, kidney failure, Parkinson’s, Alzheimer’s, cancer, and everything else. A generation of 35 million Americans (Gen X) will be working in a deflating economy to support the inflated prices of private healthcare for a generation of 70 million Americans.

    This system will self-destruct, and take the country with it, in the next five to ten years.

    We ought to discuss this, bring doctors and citizens and policymakers together to describe this historically-important moment. Instead, we are leaving the dialogue in the hands of politicians and pundits, where it unsurprisingly gets reduced to a partisan hair-pulling match.

    The future of healthcare does not require our politicians’ consent. It will arrive soon enough. It will be more serious than any policy issue we have ever faced. It will be better if we have a reasoned policy in advance. It is unlikely that such a policy will exist if left to the politicians alone.

    How shall we reframe the dialogue?

  3. collapse expand

    @ericgarland – good post. We WILL have health care reform eventually, I just hope by reform we don’t mean a total clusterfuck, which is the what it looks like from here.

    Democrats once again prove they can always snatch defeat from the jaws of victory.

    • collapse expand

      Yeah man, healthcare WILL be re-formed by reality. The question is, would we like a say in what that new form looks like? Are we hoping to prop up old institutions or form new ones around emerging conditions? Do we want clusterfuck or semi-messy coverage for all?

      If we choose “none of the above,” we can keep using old institutions for a new world. Full-time employment will slump, costs will skyrocket for private coverage, millions more will seek care at emergency rooms. Hospitals will go bankrupt and ask for bailouts from equally-broke state governments groaning under the crushing weight of their Medicaid obligations. Cost of care will continue to increase, outcomes will sink below El Salvador and Romania. Pundits will still claim that Swedish healthcare is miserable and that every citizen of the G8 wants to emigrate to the good old U S and A.

      Or maybe we can prepare something better suited to reality.

      I wonder what we will choose.

      In response to another comment. See in context »
      • collapse expand

        Your own post shows that we have no “choice.” I’m the same generation as you, and my vote gets drowned out, 2 to 1, same as yours.

        The MSM controls the debate, and it controls the framing. We cannot “choose,” in the informed, rational consent meaning of the word, unless we have the information with which to make that choice. When all, ALL, media is developed for a 5th grade audience, we Americans will never get a decent explanation of the health care debate, except for, “Public option GOOD! No, wait, public option BAD!”

        And really, how can you blame the average citizenry for apathy? Remember the world’s largest peace protest before the Iraq war? How effective was that?

        In response to another comment. See in context »
        • collapse expand

          It’s frustrating, isn’t it? The way we reframe the debate is exactly what we’re doing – talking about it in a public forum.

          Yes, yes, we all want to be on the TeeVee Box which is considered Very Important. And it feels like rational opinions are being drowned out by a sea of hypocrisy and short-sighted nonsense. This is our lot in life, at least in this moment. It’s all we can do – walk away from nonsensical media and actually talk to our neighbors. No, it’s never been tougher, but it’s the only option that even gets us in the right direction.

          In response to another comment. See in context »
  4. collapse expand

    Matt – I read the NYT several times a week and I assure you that the Herman/Chomsky propaganda model is validated on a regular basis. From foreign policy stories like the Iraqi and Afghan elections to domestic stuff like health care. Is actually quite amazing really.

  5. collapse expand
    deleted account

    I don’t agree with my colleague Matt Yglesias.

    My thoughts on the entire approach the Democrato-sphere:

    http://galiberal.com/?p=2264

  6. collapse expand

    Matt – once again you break things down clearly. The propaganda machine in this country is healthier than our people. It is disgusting. I’m tired of waiting and wishing for Americans to wake up.

  7. collapse expand

    You probably know far more about the health care insurers than I, but I just want to reinforce this: the health care debate would not now be occurring if the number of Americans covered by private insurance will be going down.

    The share of Americans fully covered by private insurance is below 50 percent, now. As Americans age, that percentage will go down, probably until the year 2050. Plus, there is a small movement among employers who are negotiating on their own with health providers, cutting out the insurance industry entirely. The only pool of Americans that can make up for this loss is the pool of the uninsured. Uninsured people will only buy private insurance only if forced, which is the main aim of Obama’s plan.

    If insurers were not in danger of losing customers, the health care debate in Congress today would be about steroid use among professional athletes.

  8. collapse expand

    colorless green ideas sleep furiously

  9. collapse expand

    And the public option battle is not lost, in case anyone is really paying attention.

  10. collapse expand

    Hey Matt. Don’t you know that your “Manufacturing Consent” theory is just a craaaaazy conspiracy threory? People don’t really sit in a conference room at the Brookings Institute and determine exactly how the policies they write will be reported on in the corporate media.

    And I’m also certain that ex CIA Director and “boating accident” victim, William Colby was just psy-opping us when he said “The Central Intelligence Agency owns everyone of any significance in the major media.”

  11. collapse expand

    The lies that define the American psyche are so tightly interwoven that to believe one means you are defenseless against all the rest. If you believe that Americans are good, hardworking, altruistic people and its the Bushes or Cheneys or Gingriches or Obamas, or even the bin Ladens, of the world that are the problem then it is impossible for you to stand up and disagree over something like healthcare reform as the entire fabric of our media and society will be there to suffocate you.

    We are being destroyed not by lies created by our politicians and coruporations but by the lies we told them we wanted to hear.

    We’ve spent at least the last three decades acclimating ourselves to a standard of living to which we wanted to become accustomed…an illusion of properity built on debt. We got used to the magic black box where you put in 100 dollars and take out a thousand and nobody asked how its done because we didn’t want to know. When asked why previous generations had to work so hard and sacrifice so much for so little gain the common answer was ‘its a different world’.

    There is no something for nothing. I don’t care if you call it the ‘public option’ or the ‘insurance industry option’. Which, when you think about it, really represent the same thing. They are both suppose to represent the magic black box where you put in a little and, Abracadabra-Presto-Chango, take out a lot!

    We are spoiled children who only have a quarter but will cry and throw a tantrum if mommy and daddy don’t allow us to buy something that costs a dollar.

    • collapse expand

      “We are spoiled children who only have a quarter but will cry and throw a tantrum if mommy and daddy don’t allow us to buy something that costs a dollar.”

      Hoo man, this is really the key issue. Neither side is dealing with inconvenient little problems like the upcoming shortage of 200,000 doctors and 800,000 nurses. We just want our unlimited healthcare, home nurses, Scooters, and MRI every time we get a headache, and by the way KEEP YOUR GREASY GOVERNMENT MITTS OF MY MEDICARE! And please pass the cost onto my children, plzkthanxbai.

      This nation is not acting like a group adults trying to form “a more perfect union,” but a giant conflagration of adolescents with million-dollar suburban starter castles demanding that endless supplies of healthcare and petroleum be laid at our doorsteps. It shouldn’t then shock us when politicos start telling us any old thing to get elected. We demand fantasy every day, and shouldn’t be shocked when it arrives.

      Wake me when the adults get here.

      In response to another comment. See in context »
  12. collapse expand

    Having had a chronic condition for 26yrs the devil is in the details. Insurance companies will be forced to accept those with pre-existing conditions…thats cool, but at what price? Thats how they effectively shut people out. I have a policy that is mandated by the State of Georgia. Its called “Assigned Risk”. If a health insurance company wants to do business in the state they have to include themselves in this program. You qualify only if you had group coverage and have exhausted COBRA (ie…you paid your full premiums for 18 months). There is no pre-existing condition clause but the deductible is high (2000.00). Its a straight 70/30 ppo. I have been a part of it for 4 yrs now and premiums have increased every year, but at least it is coverage. It is not well publicized either. Maybe this is the road they want to take…but its way out of the budgets of most people

  13. collapse expand

    That is true Fran; however, I don’t believe that was the point of the post, which is quite significant. Taibbi was not taking issue of what healthcare outcome has been achieved. Rather, he was using multiple recent media examples to support Noam Chomsky’s thesis that there are subtle (or not so subtle) machinations in place in the MSM that thwart the will of the People.

    When it appeared as if the Masses were ready to rise up in demand of a Public Option (this is after all a democracy and we do have the right to, no?) we were told on many fronts, quite condescendingly, to “Be realistic” and “accept cold-eyed fiscal reality” which is, as the Taibbi so skillfully dissects, Bull Shit. I can further reinforce his point with testimony in the form of the many disagreements I’ve had recently with friends who have been parroting that very same Bull Shit.

    Thanks for the tip; I’m picking up a copy of “Manufacturing Consent”.

    Screw the Oprah book club… we need a “Taibbi Wakes Up America” Bookclub.

  14. collapse expand

    The biggest myth out there is that there is competition in the Health Insurance sector. If there really was competition that would preclude them from raising prices higher and higher so people got less and less until it crashes and burns under the expectations of Goldman Sachs Analysts and the CEOs who dance to their tune for stock based compensation.

    Unfortunately A HREF=”http://www.countitup.us/getwidget.htm”>20,000 people have been dying a year and will continue to die until we get from here to there. If there is a mandate in this reform that forces people to spend thousands of dollars a year for a policy that is incomprehensible and a card that is accepted nowhere, then we can proclaim Washington as the place to go for Guaranteed profits and a pat on the back a few trillion for corporations that screw up.

    As far as the rest of us middle class serfs; Well WTF did we expect? They were actually going to do something for us? When was the last time that happened? This will be the final nail in the coffin for this economy too, but don’t tell that to CEOs and Elected officials who think in 3 month and 2 year time frames respectively. They really don’t care.
    No really!.

  15. collapse expand

    I find it hard to believe that Obama, or anyone else, has anyone’s best interests in mind at this point. If Congress had any interest in passing serious health care reform they would’ve done so, but instead we get this ludicrous debate about a neutered shell of a reform plan, which distracts from all of the concessions and agh fuck I can’t even finish this sentence. The Left won with a god damn mandate now do your fucking jobs and pass the damn bill and if Blue Dogs won’t play ball then give them the same treatment you’re giving freshman Senators when you threaten to cut them off from re-election funding.

  16. collapse expand

    Matt,

    It’s a sad state in America that things have to get this bad before Chomsky’s work is legitimized.

    Recognize that your roll in this drama is the outlier malcontent. A couple of RS articles is good, because they are like a lightning rod for groups of people the political elite can then marginalize all at once.

    Meanwhile the political order enjoyed by the economic/social elite on both the right and left continues.

    If the social order was threatened by work like yours, it wouldn’t have been published. Period.

  17. collapse expand

    Let me get this straight- to prove your point that the “national commercial media” is creating a phony debate, you dismiss the framing the New York Times offered, and cite Mother Jones and two bloggers as the “other side” of the phony debate.

    Meanwhile, to give one example, Rachael Maddow on MSNBC, a national cable news network owned by GE, has aired several pieces about why a public option is essential, including an episode that YOU WERE ON.

    Please explain.

    • collapse expand

      Wait… so you think Taibbi would go on a show whose discourse was compromised by the interests of Health Insurance Companies?

      Talk with dining room tables much?

      Oh and one more thing… come after Matt all you want; he is here and can defend himself. But if you so much as disparage my girl Rachel, i can guarantee you will come back in the next life as a BUTT WART.

      In response to another comment. See in context »
      • collapse expand

        seriously? butt wart? sigh.

        to clarify- usually I agree with Matt, Rachael Maddow seems ok… I just don’t see how the Chomsky explanation of the media dynamic makes any sense here.

        In response to another comment. See in context »
        • collapse expand

          the Chomsky/Herman theory allows for some alternative viewpoints to poke through the general corporate shilling that occurs. But this is very rare and frankly, rachel’s ratings are simply ok and she is not considered “mainstream” even tho she’s on a mainstream network. Matt examples were more illustriative because they are more “respected” forms of media.

          Furthermore, as liberal as MSNBC tries to paint itself, the Morning Show had an entire segment where Dylan Ratigan and another regular anchor disparaged unions, claiming they were the ones holding back american’s progress by demanding healthcare and “strong arming” the president on this public option. (hat tip to crooks and liars) Bitching about unions is just about the most big business-like thing you could do.

          In response to another comment. See in context »
          • collapse expand

            But the key point of any linguistically based analysis, and certainly Chomsky-Herman, is that the “control” happens organically; there is no conspiracy. The mechanism is obvious in the MSM, the real question is:
            Is this happening on the Internet as well?
            Will the MSW (mainstream web) become as “owned” as the broadcast and print medias? Certainly must-carry and net neutrality rules may keep pure profit motive from drowning out dissent for a while, but can love of freedom battle profit motive even to a draw?
            You would think that real alternatives to the “public option”, such as single-payer or national health service would be getting serious discussion on the web, but who’s seeing it? I’m not even in a bastion of liberality like T/S.

            In response to another comment. See in context »
          • collapse expand

            @ misterb Re: Will the MSW (mainstream web) become as “owned” as the broadcast and print medias?
            Not in the near future. Almost anyone can set up and maintain a web server that can reach a million hits in no time (as opposed to the logistical nightmare of running a successful major newspaper or broadcast studio).
            Unless internet censorship takes over, don’t think it will be a problem. this is why social media (http://www.youtube.com/watch?v=sIFYPQjYhv8) is rapidly being recognized as having a scope on par with the industrial revolution.

            In response to another comment. See in context »
    • collapse expand

      oh, and discussions of Chomsky aside, Joe Klein is a fucking moron.

      (particularly in that article, in which he seems to think that a public option involves government-employed doctors, like Britain’s NHS. jesus.)

      In response to another comment. See in context »
  18. collapse expand

    The rhetoric is ridiculous. The postering is preposterous. All the arguments are too away from the details for me and I have noticed getting details is not very easy. The general public is going to have a hard time following this. This effort is going to fizzle without a detailed articulation of the vision and where costs will be eliminated. How about this… everyone gets access to health care, everyone has to pay for it in some way (co-pays, community service, wellness strategies), set goals to reduce unnecessary costs… predominately related to adminstration (~7%), malpractice litigation (~10%), and profiteering (??). Find where the costs are and start going after the low hanging fruit. Give me the numbers, man! And yes Joe Klein is a partisan to the extreme. He spent last year doing every thing he could to get his man elected. Stretching and fabricating truth is not beyond him.

    • collapse expand

      sharkdb wrote: “set goals to reduce unnecessary costs… malpractice litigation (~10%)”

      Where do you get that 10% figure?

      This is what I’ve found:

      Malpractice costs amounted to an estimated $24 billion in 2002, but that figure represents less than 2 percent of overall health care spending. Thus, even a reduction of 25 percent to 30 percent in malpractice costs would lower health care costs by only about 0.4 percent to 0.5 percent, and the likely effect on health insurance premiums would be comparably small.

      And more recent data:

      For the third straight year, 2008 saw the lowest number of medical malpractice payments since the federal government’s National Practitioner Data Bank began tracking such data in 1990.
      The cost of the medical malpractice liability system – if measured broadly by adding all malpractice insurance premiums – fell to less than 0.6 percent of the $2.1 trillion in total national health care costs in 2006, the most recent year for which the necessary data to make such comparisons are available. The cost of actual malpractice payments fell to 0.18 percent – one-fifth of 1 percent – of all health care costs in 2006. Annual malpractice payments have subsequently fallen from $3.9 billion in 2006 to $3.6 billion in 2008, but comparative data on total health care costs are not available

      In response to another comment. See in context »
      • collapse expand

        I got it from where I look for most information… wikipedia which sources the quote to PricewaterhouseCoopers.

        “About 10 percent of the cost of medical services is linked to malpractice lawsuits and more intensive diagnostic testing due to defensive medicine… …cost of medical malpractice was 2 percent of the nation’s health-care spending and said defensive medical practices accounted for 5 percent to 9 percent of the overall expense.”

        I know liberals love lawyers, but they are an incremental part of the cost structure and a strong influence to the way medicine is practiced. Seems to me if we can lower malpractice premiums by half, we can lower costs and thousands of unnecessary cesareans every year. A 1% reduction in health care cost is a lot of money.

        In response to another comment. See in context »
        • collapse expand

          “I got it from where I look for most information… wikipedia which sources the quote to PricewaterhouseCoopers.”

          You mean this: “a January 2006 report prepared by PricewaterhouseCoopers LLP for the insurers’ group America’s Health Insurance Plans“?
          I see.
          Why don’t you quote some estimates from the Lewin Group while you’re at it.

          In addition to the previously-mentioned Public Citizen report from last month, this 2004 CBO report stated that in 2002:

          Malpractice costs… [represented] less than 2 percent of overall health care spending. Thus, even a reduction of 25 percent to 30 percent in malpractice costs would lower health care costs by only about 0.4 percent to 0.5 percent, and the likely effect on health insurance premiums would be comparably small.

          So, sure there’s probably a few dollars to be saved by tweaking the malpractice system. But if we’re talking about controlling costs in the health care system, it’s a red herring; there are a few dozen areas one should look at before getting to malpractice liability.

          But of course such facts are irrelevant to “free market” ideologues for whom tort lawyers are yet another unwelcome, evil constraint (along with government & unions) upon the ruling class’s efforts to privatize gains and socialize costs.

          In response to another comment. See in context »
          • collapse expand

            Again, there is no dispute. Look at the quote… it says “2 percent of the nation’s health-care spending and said defensive medical practices accounted for 5 percent to 9 percent of the overall expense”. The 2 percent in not in dispute. The added cost is associated with unnecessary expenses associated with defensive medical practices.

            It is not hard to understand why it is so difficult to reform health care when every special interest argues in the same way. “It’s only 2 percent of the total.” What’s wrong with eliminating all the money sponges (insurance cos, lawyers, paper pushers, whatever) associated with health care? I am sure Goldman Sachs has the same argument as they steal $100s of millions every day by manipulating markets. “We are only skimming a percent or so off the top, nobody will miss it”

            In response to another comment. See in context »
    • collapse expand

      Howabout people not even have to pay for coverage? Howabout we acknowledge that it is The Right Thing To Do, and if you need pragmatism then that it is also in the best interests of our nation to maintain the health and wellness of its citizens? We pay for it the same we pay for all of the other social services we offer.

      In response to another comment. See in context »
      • collapse expand

        I agree that the health and wellness of the nation is important. We are all in this together and at least I believe all should contribute in some way. If not a small copay, it could be just community service. Much like taxes, a new health care program should be constructed to give people incentive to do the right thing with regard to their own health.

        In response to another comment. See in context »
  19. collapse expand

    That Nate Silver argument is priceless. He’s essentially saying ‘Some guy robbed me on the street for $1,100. But it didn’t rain today, and, to me, that’s worth $1,100.’

  20. collapse expand

    “If the national commercial media really did exist solely to perpetuate the attitudes of the political elite, and to create phony debates around unthreatening policy poles, endlessly pitting a conservative/reactionary status quo against an “acceptable” position of dissent — if that thesis were the absolute truth, then you’d see just what we’re seeing now in the coverage of the health care debate”

    That is a pretty bad misreading of MC. MC’s thesis is that the mass media’s business is selling an audience of affluent consumers to a market of other affluent corporations. The incidental effect of this market structure is that the media adopts the interests and class identity of the markets it serves and the corporations that own them and reflects the narrow range of acceptable opinions found therein. Those interests happen to put the media’s coverage, assumptions and priorities in alignment with the same government that those same elites have captured. (See Goldman Sachs.)

    In other words, the media does not exist solely to create phony debates, it exists to make money and in doing so it incidentally creates phony debates by the nature of the markets it serves.

  21. collapse expand

    Health Insurance as a business can only work for the corporation not the customer – as it is currently clearly doing.

    When people want to mitigate a risk, they can shop for insurance and weigh the premium cost against their ability to withstand the consequences of a bad event and it’s likelihood. They can afford to either buy the insurance or take their chances. When you get sick or injured, you are more often than not in a life or death situation (either because of the direct consequences on your health or your resulting inability to be able to work and make a living). I will pay anything for this policy because if I don’t have it, I could die or live miserably. The private health insurance company then charges exorbitant premiums and in order to really maximize profits, goes to great lengths to not pay claims.

    This (our current) system can only make sense for the private health insurance company. We therefore absolutely need the public option at a minimum.

    • collapse expand

      You say you would “pay anything for this policy”. Really?

      Would you starve to death for this policy? Would you allow your children to go without clothes? Would you become a slave for this policy?

      I’m not being sarcastic. This is where this is headed. Many people are already what is known as ‘insurance poor’. They make a decent living but actually pay insurance companies (house, car, life, health etc) more than they pay themselves!

      For thousands of years no one had insurance and now its indispensable??? What changed?

      I’ve got news for you…you ARE going to die. If you get seriously injured or sick you ARE going to suffer. The solution to exploding healthcare costs is to get rid of health insurance and in the process a magical thing will happen…healthcare costs will decline dramatically. The government’s only role should be to provide assistance for the indigent and in cases where a health catastrophe would result in indigence.

      If you believe healthcare is a right tell that to over half the world’s population who live on less than two dollars a day.

      America, land of the free and home of the entitled.

      Entitled by by whom?

      In response to another comment. See in context »
  22. collapse expand

    “The most prominent voices in the last two days have mostly chosen one of two sides to argue.”

    True, except for those against any reform. And those against letting go of the public option at all. I hear, for example, that there’s a prominent magazine writer and TV pundit who has a column to this effect in one of the nation’s biggest magazines right now!

  23. collapse expand

    Manufacturing consent is a classic. If you haven’t read Walter Lippmann’s “Public Opinion” or Edward Bernay’s “Propaganda” (apparently the 1920’s was a more honest time), which Chomsky extensively references, you ought to. With disturbing eloquence, they describe why the “specialized class” needs to control public opinion by feeding the public meaningless stereotypes (e.g. socialism is evil) and myths (e.g. America is the greatest Country), narrowing the boundaries of debate(e.g. the NYTimes is liberal and EVEN they say single payer is left of Moscow, ergo if you advocate for single payer you are likely backslapping buddies with Stalin), and to marginalize decent of the business class and ruling elite (e.g. Matt Taibbi is a polemic, anti-capitalistic, and probably bankrolled by Hugo Chavez).

    It is with striking clarity and honesty that they argue that democracy should be rendered into the mere saturation of images and cliches onto the body politic, which propagates myths and enables the “cool observer” to lead by virtue of a system of “benign subjugation”.
    The unruly, ignorant hoards (i.e. the public) would be able to engage only in insignificant decision making like whether they buy Regular Crest of Crest with Whitestripe Gel! They are afforded the illusion of choice and freedom, but play no meaningful role in important decision making like when/where we should deploy our armed forces or whether we should form a healthcare system that promotes health.

    Attempt to describe this to unsuspecting individuals and you are labelled a conspiracy artist, which is why the propaganda model is impervious to critique or any institutional analysis. It’s simply brilliant.

    • collapse expand

      Yep, he’s been a menace to Lloyd “The Head Vampire” Bankflayer and his ilk… to the rest of America, whether they realize or not, he is Robin frikkin’ Hood! (and i’m talking about $600 million in G$ warrants) Although, that wasn’t even remotely stealing from the rich, just enforcing some justice where none existed prior. Hell he’s better than RH; he is The Taibbi!!

      In response to another comment. See in context »
  24. collapse expand

    Was the “public option” ever more real than the tea offered to Alice? Now the madmen have decided that it’s time to convince all those that said yes to the offer that they weren’t after all thirsty enough to have any tea.

  25. collapse expand

    The thing that bothers me most about this debate is the lack of facts and figures used to describe the pros and cons to it, regardless of what side of the issue you’re on.

    The case should be pretty easy to present and win if the facts are on your side, so why isn’t either party doing that? Probably because pandering to a human being’s sense of morals and common decency is the only way to push your agenda (whatever it is).

    It seems that rationality has taken a vacation in the last 15+ years when it comes to any sort of discussion regarding anything political. Obama’s People are going to kill my grandma, Republicans strangle puppies, and libertarians are all insane.

    The people who do actually make it on the news and present facts and figures seem to either get paid a few moments of serious attention then it’s back to irrationality, they get laughed at, or they’re on the wrong side of the issue and are overwhelmed by the mob mentality of the other side.

  26. collapse expand

    .What we might get in the end is a medical insurance bill, with a limp-dick quadruple-loophole infested political fart praised by a choir of paid off congressional a-holes……if they abandon the checks and balances of the public plan, and just rely on back room concessions with the health industry, real reform will be impotent in my opinion, because the Health Industry will say yes to concessions of “pre-existing conditions” and to “not dropping folks” and the administration will pass a law that everyone will have to have insurance, and there will be no real cost control. Health Care gets more patients and the consumer gets what? a tax penalty for not having insurance and a health care industry that works like a monopoly. The Health Care Clearinghouse sort to speak will have choices all that cost the same for the same benefit all rationed by a Health Care Actuary that sets prices at 80% of premiums paid….Obama better get a hold of the message hear, or meaningful reform will get turned into “just get something passed”. Its time to lead….

  27. collapse expand

    I personally don’t like the medical industry monetizing my health which is why I feel the public option is the only option. Without it, they can claim any kind of victory they wish, but it’s going to smell like the same pharmaceutical giveaway Bush “victory”.

  28. collapse expand

    Matt,

    What about getting “Rolling Stone” to post your ENTIRE article “Health Care Reform: The Big Sellout” on their web site instead of just your videos? How about pointing out to “Rolling Stone” that this would be in the public interest (heaven forbid that ANY corporation cares about furthering the national dialogue!!!) to have your article widely available? That “Rolling Stone” would get a LOT of advertising hits? That it’s just going to get on the internet anyway (I PERSONALLY was able to both download a PDF copy of “The Great American Bubble Machine” AND read the entire article on a blog before “Rolling Stone” FINALLY posted the entire article online) but that others will get the advertising hits instead of “Rolling Stone”?

    Also, what about getting “Rolling Stone” to post the ENTIRE “The Class Clowns” article, which appeared in the April 15, 2009 issue and is NOT available on newstands any longer???!!! What about asking “Rolling Stone” to publish the entire article that Tim Dickerson has written in past months, such as “The GOP Jihad” published in the May 13, 2009 issue and “The ‘Death Tax’ Scam,” published in the May 27, 2009 issue? NONE OF THESE ARTICLES are “available on newstands.”

    Why is “Rolling Stone” being such a prick? I can understand why “Rolling Stone” may not want to post articles online while an article in in a magazine that is currently on newstands. But three months AFTER the magazine has been taken off newstands and is NOT available???

    So if “Rolling Stone” wants to be a “player” in politics, why is the magazine denying millions of people access to your articles even AFTER they are no longer available on newstands. Ask them that question, please? Do us that service, please, and then let us know their response.

  29. collapse expand

    Well, these pundits are fooling themselves if they think these half-wits will be able to put together a good health care bill. Remember last summer when Obama and the Democrats buckled on the FISA bill, and they made all these assurances that the clarifying language and the inspector general’s oversight powers would make everything all better? That’s how the Democrats’ health care bill will be, with or without a public option.

  30. collapse expand

    The problem is that without the public option, the other good stuff–ESPECIALLY the so-called guarantee that no one will be refused care because of pre-existing conditions–won’t mean much or be enforceable. Private insurers have plenty of ways to nefariously deny supposedly insured consumers the care they need. Unless there’s a public option WIDELY AVAILABLE TO EVERYONE to keep the for-profit insurers honest (scratch that: to RENDER THEM HONEST FOR THE FIRST TIME IN THEIR HORRID EXISTENCE), we’ll end up with pretty much the same cruel system we have today, though it will be years before everyone figures out that, as Frank Rich put it, we’ve been punked.

    • collapse expand

      I don’t understand. What makes you think that the government-run public option health plan isn’t going to be every bit as, or much more, impersonal, cruel, bureaucratic, uncaring than private insurers? Why such trust that they will run this thing wonderfully, when we’re sitting here right now talking about what incompetent, soulless boobs they are?

      In response to another comment. See in context »
  31. collapse expand

    Ah Matt, I wish I had seen this post before I wrote my own, in which I completely agree with you.

    http://healthcare09.net/2009/08/22/what-the-strategy-for-defeat-will-be/

  32. collapse expand

    I just saw the show “Political Mann” hosted by Jonathan Mann on CNN discussing health care. The first thing he said was a record number of people are against health care reform… Phwaat? Last I saw, 72% were in favour of it. I’ve got no idea what poll he’s citing but there’s gotta be some twisting going on there.

  33. collapse expand

    Hey Matt -

    Check out what George Carlin has to say about all the “Nuanced” Health Care Debacle B.S. —

    http://blameblakeart.wordpress.com

  34. collapse expand

    None so blind as those who will not see but the script is patently obvious to the less than starry-eyed.

    Wasn’t it mere months ago that the public option was a compromise substitute for a single-payer plan that political toadies determined to be unattainable (i.e. unacceptable to congressional corporate clients)?

    Now it’s cheap jewelry.

    Months of ludicrous posturing about reaching a “bipartisan” agreement–during which, no matter what is passed, secret deals are cut limiting constraints on PhARMA profits and prohibiting negotiated drug pricing.

    Now Kabuki Democrats are tired of Republican intransigence and willing to use Budget Reconciliation procedures to pass reform legislation by a simple majority.

    The trouble is (Surprise!) those procedures will require stripping the public option from the bill. Gosh! Who could have foreseen that handing over the bill’s fate to Budget Chairman and ardent public plan foe, Kent Conrad, would produce a bill without a public option?

    If Democrats were unconcerned about bipartisanship and serious about a public option, they’d let the Senate bill pass without that provision and insist on it’s inclusion during conference with the House. After all, it doesn’t matter what either chamber initially passes–what both chambers finally agree to is what becomes law, and conference reports can’t be filibustered.

    But one of the few objection that can be raised against consideration of a conference report is if it contains language violating Senate rules-like, you guessed it: noncompliance with The Budget Act. One could say using Reconciliation may be the ONLY way of ensuring a public option doesn’t become law.

    And a one, and a two, and a…. Cue the bubble machine.

  35. collapse expand

    @ericgarland, I think the way you reframe the debate is to look at two for profit industries. The insurance industry will accept prohibitions on pre-existing conditions clauses, and booting people of their plans if they get too sick, because it ultimately does nothing to their bottom line. Why? because all competitors in the market will be subject to the “new” rules and all competitors in the market will pass on the costs to us as efficient intermediaries of risk should do. That’s fine, but what would make them more efficient and help reduce costs even further? Is it the public option? What does the public option mean anyway? And why is it that Health insurance is a “for profit” industry in the first place? What would the system look like if both the insurance industry and big pharma were non-profit industries? The arguments I would expect to hear are along the lines of something like non-profits wouldn’t be as efficient, or there would be no incentive keep up the innovation we seem to be so proud of. But then we might look at the function of our universities again and ask, why aren’t they the engines of our innovation instead of big pharma? I’m all for free markets, but when we see two markets, one for insurance and one for medicine, that are performing so poorly for society as a whole, shouldn’t we take a look at what motivates them? Somewhere in all that noise are the root problems that we’re trying to correct with public policy. I agree with @sharkdb in this, until someone can clearly articulate what it is we are trying to do and how it is we plan to do it, is it any wonder the media is lost and no one understands what they are arguing about?

    • collapse expand

      When you talk about the failure of the insurance and medicine “markets”, do you acknowledge that they already have tons of government involvement, such as extensive regulation and the Medicare program?

      I don’t think it is fair for anyone to draw any simple conclusions about “free markets in healthcare don’t work” or “government involvement in healthcare doesn’t work” by looking at our current system. It’s not a particular good example of anybody’s ideal. It’s a great example of a mixed-up mess.

      The main thing that is messed up about healthcare coverage isn’t even being addressed by the plan: that it is heavily tied to employment because of tax incentives. Why not start out by adjusting tax incentives to give individuals control over their healthcare spending?

      In response to another comment. See in context »
      • collapse expand

        Mike, Sure I’ll acknowledge your point and say sometimes meddling with free markets leads to inefficiencies and unintended consequences, but in the case of something like pre-existing conditions or declining coverage to the insured when they really need it, are problems outside of your argument. In those two specific cases, the profit motive that drives insurance companies to seek out only the best clients is in direct conflict with our best interests.

        We want efficient intermediaries of risk to be sure, so adjusting tax incentives and decentralizing healthcare spending might make sense, if it helps the system become more efficient. But I’ll argue that that has nothing to do with screwing people out of coverage, which is also part of the problem. So as we look for solutions to all aspects of this mixed-up mess let’s not blithely assume profit driven economics and free markets are the solution. I think we’re looking for a hybrid.

        In response to another comment. See in context »
  36. collapse expand

    Almost all of the public debate misses the point of what role insurance is capable of playing. Insurance is useful for paying for unexpected health crises that hit at an earlier age than expected.

    It is not a suitable method for paying all the normal medical expenses of the elderly. There is no perfect solution for that problem, but what people need to be able to do is save up for old age, to accumulate wealth. We can’t do that when the government is sucking the value out of the economy with foreign wars, bailouts, and wasteful, centralized healthcare programs. We can’t do that when the government is sucking the value out of the dollars in our savings accounts with massive deficit spending.

  37. collapse expand

    Here’s something trivial, but supportive of our sheep-like ability to repeat phrases: isn’t “pre-existing” redundant.

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