I heard that that while Wyden-Bennett has been seemingly overlooked, there’s a proposed Wyden Amendment to the Baucus bill which would expand choice for those using employer-sponsored plans. Anyone here know the story behind why Wyden-Bennett never gained traction?

There’s no way it can get to 60 in the US Senate. Unions hate it because it attempts to replace employer-based insurance. It increases taxes by eliminating the Employer Tax Deduction, so very few Republicans will support it. It makes all politicians uncomfortable because it would screw around with half the country’s health care.

The traction it gets tends to come from unelected wonks (like me and Ezra Klein), and Senators who want to look bipartisan. Some former sponsors, for example, now publicly castigate the bill.

Ryan said:

If that’s the case and this bill authorizes that without mandating employers to seek other types of coverage, I’m in favor of it. The credit union model is brilliant and credit unions routinely get better ratings than your run-of-the-mill commercial bank.

The worry is that these co-ops would be too small to be viable. Health Insurance companies need a big risk pool if they are to survive. That means hundreds of thousands of members. If one member has twins prematurely the bill is probably gonna be in the $4-$5 million range. Spread out among 1,000 co-op members that’s $4,000-$5,000. At 10,000, or 20,000 the numbers work out better, but they’re still screwed if one chick has premature twins, two more get cancer, and a fourth member has to be a airlifted top the hospital after a skiing accident.

Given that Wyoming has roughly 500,000 people, that exchanges will cover roughly 15% of the population Wyoming’s co-op would only have a total market of 75,000 or so. 20% market share would be 15,000 members, and that’s probably too small to be viable.

It would have another major disadvantage, particularly paying for the dude with a skiing accident. Why should a Denver hospital give a tiny co-op from Wyoming that 60% discount it just gave the big players in it’s state? Or a Chicago hospital? Is it even possible for a 15,000 member co-op from Wyoming negotiate deals with hospitals nation-wide?

The public option gets around those problems mostly because it’s huge. It will have millions of members. They will be nation-wide. A strong public option avoids the second problem by paying medicare rates, or Medicare rates plus a bit. Medicare doesn’t negotiate with hospitals. It prints a price list (aka: a fee schedule) and hospitals take it or leave it.

Ryan said:

However, what I’m failing to see is how this bill covers the uninsured or underinsured. I’m all about bringing the cost down, but what about those of us who are underemployed and are *not* able to get coverage either via employer or an outside provider due to cost?

If you are poor you get subsidies. So the unemployed, and most of the formerly uninsured, will get policies for virtually nothing. The subsidies apply to everyone under 300% of poverty (Baucus, ’cause he’s cheap), or 400% of poverty (everyone else because they’re liberals and they like spending money).

If you are uninsured and well off you have to buy a policy, at full price. If you have a pre-existing condition this plan saves you a bundle because insurers can’t charge you through the nose, or decide they won’t pay for a treatment.

This screws the 20-somethings with money and no insurance, but 20-somethings with money and no insurance tend to turn into 50-somethings with heart trouble. In the end even they will save money.

Nick

I’ve thought about changing my screen name to “That A-Hole Reynolds.”

But Justin’s post and so much other commentary about this errs in assuming that this is about developing a “bi-partisan” bill. That’s the way Baucus and others have cast it because to the huge center of American politics — among the independents and moderate Democrats and Republicans who are tilted all those polls against more radical changes — bi-partisanship is a Good Thing and a handy way to express moderation.

What Baucus has actually been trying to do all these weeks is to develop a bill HE can support and that the other 10, 12 or so centrist Democrats in the Senate can support. In the process, if he could snare a few moderate GOP votes, all the better. But make no mistake: this is all about bringing the Democrats together to pass a bill.

Blackout…the reason Wyden/Bennett isn’t being proposed is it would be a complete upheaval of the way we pay for insurance and while it makes A LOT of sense…there’s simply not enough political will. Basically, anybody who has insurance through their employer would lose it, along with the tax exempt status of the payments and would then have to purchase via another program.

If you think people cried socialism now, well, just try taking away their employer insurance. :-)

Ryan, co-ops are for the uninsured or underinsured. Everybody else simply keeps their coverage.

If that’s the case and this bill authorizes that without mandating employers to seek other types of coverage, I’m in favor of it. The credit union model is brilliant and credit unions routinely get better ratings than your run-of-the-mill commercial bank.

However, what I’m failing to see is how this bill covers the uninsured or underinsured. I’m all about bringing the cost down, but what about those of us who are underemployed and are *not* able to get coverage either via employer or an outside provider due to cost?

That’s what has Justin so annoyed. He really believes in bipartisanship, so he supported their negotiations. And they were apparently using him to advance their partisan agenda of stalling reform.

Snowe is a bit different. It’s possible she could support a non-stupid bill. Unfortunately for Baucus his bill is pretty stupid, so she’d be a fool to support it.

I’ve written quite extensively on all of this in another thread on this same site. So I’m clearly not changing the subject, or avoiding the subject, or refusing to back my position. I thought it would be rude to cut and paste my extensive remarks into every comment thread. But if you’d like I can do that.

But I guess I am being silly to think you’d actually try to defend your repeated “blame backwards rednecks and racists for every Obama failing all the time” contentions.

As I’ve said many time before, I like Obama. Not a little bit, but a LOT. But I know that he swept in on the biggest wave of a cult of personality that I’ve seen in modern American politics in some time. Since I like the guy, I am not saying there is necessarily something wrong with it. That always brings a backlash. Cult of personality stuff can be very creepy to the folks not buying in. Obama derangement, where it can be found, seems to be at least as bad as Bush derangement. Perhaps in some cases worse.

Big fat oh well for the folks who want Obama to succeed. The options are to overcome it or to fail. Whining that it’s the reason for failure? Not useful or effective. Not in my opinion. Maybe you just have more faith than I do in the efficacy of whining.

And you’re not very impressive when you don’t have Tully to rush to your rescue.

Tully at least would have the wit not to resort to “Mikey.” Maybe you should email him. Get some help.

Folks, this is the best Republicans can hope for. If they don’t like it, fine, but what do they want? What does realistic compromise look like to them? I have NO idea and neither does anybody in the moderate Republicans blogosphere…which should tell you all you need to know.

The Republicans don’t accept the premise that “something must be done right now.” So they feel no compulsion to compromise simply in order to “do something.” The Republicans are not interested in compromising in order to help pass a bill that goes way against their fundamental ideals. Nor should they, IMO. Not if they genuinely feel its a fundamentally wrong-headed approach. I take most GOP legislators at their word when they express the belief that wider-scale government involvement is a terrible idea. I don’t agree, but I believe they’re basically sincere. They’re playing no more politics than democrats when Bush was in office, at least.

Suppose Abraham Lincoln, Ronald Reagan and Jesus Christ co-sponsored a health reform bill that did not raise taxes or increase government involvement. Suppose instead that it used tax credits to help low-income families buy private healthcare and allowed more leeway for various insurance companies to provide different levels of coverage. They’d support that. No doubt in my mind.

Not saying those are good ideas. But I have no doubt that the GOP would support a bill with Republican ideas.To suggest otherwise is silly. Michael, you’ve become a genuinely silly guy since you went head first into the tank for Obama. It’s been “blame backwards rednecks and racists for every Obama failing all the time.”

Mikey, you used to do way better than your recent posts when you captained the mighty middle. Now you’re just mighty silly.

I don’t think the GOP has any sort of comprehensive vision or plan to improve our healthcare system. But I also think that GOP legislators have the right to their views, and the responsibility to act in accordance with the principles thus derived.

That means its up to democrats. If they are certain that something must be done, it’s within their power to do something, without any GOP help, via reconciliation if necessary. And then they will OWN the resulting reform, for better or worse. Personally, I don’t think democrats are genuinely convinced that something must be done, that we face a crisis. If they really believed that, they’d be willing to pay the price to ram something through for the good of the country.

But they AREN’T willing to pay that price. because it’ll be a big one. Why? Because while many Americans agree that “something” must be done, they don’t agree on what that something is, unless it’s “make MY costs go down and/or improve MY coverage access.” Obviously, we can’t all have that. So as soon as the vague “something” becomes a concrete something, the folks whose oxen get gored will be all pissed off. Democracy is a bitch.

If Abraham Lincoln, Ronald Reagan and Jesus Christ co-sponsored a health reform bill they wouldn’t get a single GOP vote. Not so long as Obama is in office. It’s all Obama-hate, all the time.

Some shocking news, unless he’s just saying for ratings O’Reilly Endorses Public Option.

http://thinkprogress.org/2009/09/17/oreilly-public-option/