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Insurer targeted HIV patients to drop coverage.
March 17, 2010 2:03 PM Subscribe

"In May, 2002, Jerome Mitchell, a 17-year old college freshman from rural South Carolina, learned he had contracted HIV. The news, of course, was devastating, but Mitchell believed that he had one thing going for him: On his own initiative, in anticipation of his first year in college, he had purchased his own health insurance. Shortly after his diagnosis, however, his insurance company, Fortis [now Assurant Health], revoked his policy. Mitchell was told that without further treatment his HIV would become full-blown AIDS within a year or two and he would most likely die within two years after that."

"Previously undisclosed records from Mitchell's case reveal that Fortis had a company policy of targeting policyholders with HIV. A computer program and algorithm targeted every policyholder recently diagnosed with HIV for an automatic fraud investigation, as the company searched for any pretext to revoke their policy. As was the case with Mitchell, their insurance policies often were canceled on erroneous information, the flimsiest of evidence, or for no good reason at all, according to the court documents and interviews with state and federal investigators."

"And as the story points out, the evidence is that the overwhelming majority of rescissions, not just at Assurant but across the board, are, in fact, without justification."*

posted by ericb (139 comments total) 19 users marked this as a favorite

If it’s any consolation:

"In 2004, a jury in Florence County, South Carolina, ordered Assurant Health, part of Assurant Inc, to pay Mitchell $15 million for wrongly revoking his heath insurance policy. In September 2009, the South Carolina Supreme Court upheld the lower court's verdict, although the court reduced the amount to be paid him to $10 million."

posted by ericb at 2:04 PM on March 17, 2010 [1 favorite]

Gotta love it.

One of Assurant Health's tag lines (on their website) is:

"Confidence is contagious."

posted by ericb at 2:05 PM on March 17, 2010 [9 favorites]

"blah blah blah moral hazard blah blah blah" - this message brought to you by the Tea Party
posted by GuyZero at 2:09 PM on March 17, 2010 [7 favorites]

Knowingly failing to deliver on contracted insurance is insurance fraud, no less than wrongly claiming on insurance would be, and it should be prosecuted as such.
posted by aeschenkarnos at 2:10 PM on March 17, 2010 [21 favorites]

BUT WILL SOMEONE THINK OF THE SHAREHOLDERS
posted by lalochezia at 2:10 PM on March 17, 2010 [19 favorites]

Gee, these kinds of things are news to me.

There oughta be a law!
posted by markkraft at 2:11 PM on March 17, 2010 [3 favorites]

AHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH!!!!!!!!!!!!!!!!!!
posted by Lutoslawski at 2:11 PM on March 17, 2010

Fuck that. Knowingly failing to deliver on contracted insurance that will result in death from AIDS is either negligent homocide or murder and it should be prosecuted as such. I'm sick of this crap.
posted by Babblesort at 2:13 PM on March 17, 2010 [52 favorites]

From the link:
Insurance companies have long engaged in the practice of "rescission," whereby they investigate policyholders shortly after they've been diagnosed with life-threatening illnesses....

A 2007 investigation by a California state regulatory agency, the California Department of Managed Health Care, bore this out. The DMHC randomly selected 90 instances in which Anthem Blue Cross of California, one of WellPoint's largest subsidiaries, canceled the insurance of policy holders after diagnoses with costly or life-threatening illnesses to determine how many were legally justified. The result: The agency concluded that Anthem Blue Cross lacked legal grounds for canceling policies in every single instance....

Fortis pre-programed its computer to recognize the billing codes for expensive health conditions, which triggers an automatic fraud investigation by its "Cost Containment" division whenever such a code is recognized...an investigation last summer by the House Energy and Commerce Committee as well as earlier ones by state regulators in California, New York and Connecticut, found that thousands of vulnerable and seriously ill policyholders have had their coverage canceled by many of the nation's largest insurance companies without any legal basis. The congressional committee found that three insurance companies alone saved at least $300 million over five years from rescission.

Maybe replace "rescission" with "murder," or at least "total fucking lack of human decency."
posted by sallybrown at 2:14 PM on March 17, 2010 [40 favorites]

Frontline's Sick Around America has a bunch more rescission stories that will make you want to murder everyone within fifty feet of you.
posted by The Straightener at 2:14 PM on March 17, 2010 [4 favorites]

That's why we need this bill. I'm glad Kucinich is now on board. Will bring a few Blue Dogs with him.
posted by Ironmouth at 2:14 PM on March 17, 2010 [2 favorites]

Yet another reason why the profit motive needs to be removed from health care altogether.
posted by Saxon Kane at 2:18 PM on March 17, 2010 [45 favorites]

This is why we need to destroy the health insurance industry utterly and salt the ground where their offices were. But that might lose us some Blue Dog votes.
posted by vibrotronica at 2:19 PM on March 17, 2010 [26 favorites]

Frontline's Sick Around America has a bunch more rescission stories that will make you want to murder everyone within fifty feet of you.

I've never been within fifty feet of every health insurance executive in the US, but apparently I need to start!
posted by Pope Guilty at 2:21 PM on March 17, 2010 [1 favorite]

Knowingly failing to deliver on contracted insurance is insurance fraud, no less than wrongly claiming on insurance would be, and it should be prosecuted as such.

Except that Assurant didn't fail to deliver. They simply canceled the contract, thus there was no contact to fail to deliver on. "Failure to deliver" implies there was a contract in-force. There wasn't.
posted by Thorzdad at 2:23 PM on March 17, 2010

"blah blah blah moral hazard blah blah blah" - this message brought to you by the Tea Party

Moral hazard is what happens when you know someone else will bail you out of a jam, so you do stupid shit. That's a lot of why we got into such a huge mess in the banking system, because they knew full well that the Federal government would not let bad things happen if they were sufficiently bad. That gave them every reason to structure deals to maximize short term profit, while maximizing long-term risk.... because the risk would be borne by the taxpayers if and only if it was big enough.

I'm not sure how that idea links here. As aeschenkarnos says, this is insurance fraud, pure and simple. People at that company should be doing jail time. A $10 million settlement means nothing; they'll just pass that along to the policyholders.
posted by Malor at 2:23 PM on March 17, 2010 [1 favorite]

That's why we need this bill. I'm glad Kucinich is now on board. Will bring a few Blue Dogs with him

Does the bill include provisions to force insurance companies to grant coverage? Without a public option, it doesn't seem like much would have changed for Jerome even under the new bill. Do you know of a provision that would have helped him?
posted by Blazecock Pileon at 2:23 PM on March 17, 2010

Ironmouth: "That's why we need this bill."

I'm sure that the government will enforce the new consumer protections against the health insurers as diligently as they have regulated Wall Street.
posted by Joe Beese at 2:24 PM on March 17, 2010 [12 favorites]

Moral hazard is what happens when you know someone else will bail you out of a jam, so you do stupid shit.

Like contract HIV?

I think that's what's being said above
posted by phrontist at 2:25 PM on March 17, 2010 [1 favorite]

I fully understand Kucinich's reluctance, but on balance I think passage will be a good thing, and I am glad he is on the yea side. Not perfect by any stretch of the imagination, however, there is a long history of broadly popular and progressive legislation that has started in similar situations. In fact I think what the Republicans are truly concerned about, even though they won't come out and make it a central part of their so-called arguments, is that what will (possibly) get passed here is basically a framework on which improvements will be made over time.

I don't think many congress people want to go through another fucking summer like last one.

And yeah there will be a lot of bitching and moaning about it, socialism vs corporate sell out.
posted by edgeways at 2:26 PM on March 17, 2010 [1 favorite]

That's why we need this bill.

Doesn't the bill still allow rescission in case of "fraud?" And isn't "fraud" the grounds on which all these rescissions have been justified to begin with? What changes, exactly?
posted by enn at 2:26 PM on March 17, 2010 [2 favorites]

Private insurance companies weasel out of claims. News at 11.

That's why critical medicine should be taken away from them - they've abused their market and deserve censure. Let them wiggle their toes in dental work, chiropractic and optometry and leave the major organs to an impartial not-for-profit insurer.

In British Columbia, folks got so pissed off with this shenanigans they even created a public option for car insurance way back in 1973.
posted by CynicalKnight at 2:29 PM on March 17, 2010 [1 favorite]

phrontist: Like contract HIV?

I think that's what's being said above

You know, my eyes actually got wider when I read that. I sure hope you're wrong in that reading, because that argument would be one of the more vile ideas I've seen.
posted by Malor at 2:32 PM on March 17, 2010

Does the bill include provisions to force insurance companies to grant coverage? Without a public option, it doesn't seem like much would have changed for Jerome even under the new bill. Do you know of a provision that would have helped him?

Ostensibly, it bans the practice of rescission completely (not that the media noise-machine let anyone notice). Some argue the specific form of the ban potentially leaves open a big loophole, but it includes provisions the stated intent of which is to prevent the practice of rescission.
posted by saulgoodman at 2:32 PM on March 17, 2010

'shenanigans' looks pretty plural, but I'm not sure I've ever seen or heard of anyone commiting a 'shenanigan' and thusly I weasel out of responsibility for my poor trade school grammer.
posted by CynicalKnight at 2:32 PM on March 17, 2010

We *do* actually need to think of the insurance companies. As I understood it, the point of the public option was to make insuring needy people financially possible in cases where the private sector simply struggles to make it work. Right?
posted by honest knave at 2:33 PM on March 17, 2010

It's a singular shenanigan when you wake up the next morning and you're only missing one pant.
posted by nebulawindphone at 2:36 PM on March 17, 2010 [2 favorites]

honest knave: "We *do* actually need to think of the insurance companies. As I understood it, the point of the public option was to make insuring needy people financially possible in cases where the private sector simply struggles to make it work. Right?"

My progressive friend, the public option was only a means to an end.

[New York Times Washington reporter David] Kirkpatrick... acknowledged that White House Deputy Chief of Staff Jim Messina had confirmed the existence of the deal to him.

... Even while President Obama was saying that he thought a public option was a good idea and encouraging supporters to believe his healthcare plan would include one, he had promised for-profit hospital lobbyists that there would be no public option in the final bill.
posted by Joe Beese at 2:39 PM on March 17, 2010 [2 favorites]

Doesn't the bill still allow rescission in case of "fraud?" And isn't "fraud" the grounds on which all these rescissions have been justified to begin with? What changes, exactly?

It's been suggested there's wiggle room in the policy, but the intent of the provisions is clear, so once implemented, the intent should be clear enough to smooth over any attempts to get around the rule as written.

Here's some more on this issue.

As I understand it, the only grounds for terminating a policy under the new rules is if the insurance company can prove deliberate fraud--that someone specifically lied about a costly medical condition to get coverage. But since preexisting conditions can't be excluded anymore, I'm not sure how/why that would ever happen in practice anyway.

Most people seem to agree, the rules proposed now would effectively end the practice.
posted by saulgoodman at 2:40 PM on March 17, 2010 [1 favorite]

Seeing stuff like this makes me think that we have in some ways gone back to the late 1980s and early 1990s when it comes to people with HIV/AIDS. Back then, the big thing was viatical life settlements, which made insurers rub their hands together gleefully and salivate prodigiously. Now that people with HIV/AIDS are actually living longer instead of dying within 2-3 years, not so much.
posted by blucevalo at 2:41 PM on March 17, 2010

Kucinich isn't going to bring anyone with him, Ironmouth. I hate to say it, because he is...

a. my congressperson
b. totally fucking awesome (no, really, his constituent services are legendary), and I have to say I was WELL pissed off to see some morons protesting outside his office yesterday, not to mention all the "call Kucinich and tell him to vote with us" bullying calls households like ours were getting
c. right an awful lot of the time (come on -- boy mayor's been through assassination attempts by the NE Ohio mob, he took on a corrupt bunch of asshole utility guys and got proven right SO HARD, you name it -- oh, and he voted against the Patriot act, too)

etc. However, in the popular (mis)conception, he is

a. insane
b. envied/jealousy-inducing (have you seen his wife? I mean, really)
c. not to be taken seriously because he's a vegan, likes peace, is from Cleveland, whatever.

Also note: he's poor as can be, by Congressional standards. (See here, though I'm pretty sure those numbers are way off -- on the high side! he lives in a neighborhood very close to mine, albeit not quite as nice, so believe me when I say if his house is worth over $100,000 in this market, I'll eat my hat).

Compare him to a complete fucking fraud of a lawmaker like Lieberman, and you'll see what happens when you suck on the corporate teat instead of working for your constituents like Kucinich does.

......... [ADJUSTING: turning off First Semester College Marxist Mode...
......... [ADJUSTING: turning on Reasonable Yet Frustrated 35-year-old College Educated Female Democrat Mode
......... [ADJUSTMENT COMPLETE

So yeah. None of the stuff in this story surprises me at ALL. What surprises me is that anyone thinks we're going to get a fair, and actually revised health care system in this country so long as the insurance companies and medical lobbyists get their way every time. I was listening to Michael Moore on NPR this morning (yes, yes, my god, it's like every Tea Party fantasy about what Democrats do all rolled into one), and he made the point that with the crazy low suggested fines the insurance companies will incur for not covering a preexisting condition, it'll work out cheaper for them to take the fine rather than pay for the treatment, in many cases.

Similarly, ok, Mitchell won a judgment against Assurant for 15 million -- great, fine. But not everyone's going to be able to file (and win) a lawsuit when they are seriously sick. There's no checks and balances on the system, it is heavily weighted in favor of the insurance companies, and it just makes me want to punch things.

It's only going to get worse if we give in on a less than GREAT solution, and that's what Kucinich was kicking and screaming about before Rahm Emanuel threatened to kill a puppy every hour until he complied, or whatever it was they did to bring him into line.

Sad.
posted by bitter-girl.com at 2:43 PM on March 17, 2010 [30 favorites]

Confidence is contagious.

confidence (kŏn'fĭ-dəns)
adj. Of, relating to, or involving a swindle or fraud: a confidence scheme; a confidence trickster.

Yep, sounds about right.
posted by Sys Rq at 2:43 PM on March 17, 2010 [6 favorites]

Yet another reason why the profit motive needs to be removed from health care altogether.

Quick story. A good buddy of mine with HIV recently finished up his chemotherapy to treat testicular cancer. He began his chemo at a private hospital where he lived in Bangkok before finishing up at a vet hospital in LA. The vet hospital couldn't believe that the overseas hospital hadn't removed his cancerous testicle. Apparently, it's the first thing which is supposed to be done as a sort of marker. So why didn't they remove it? Because something like 90% of their clientèle are from the Gulf States. Try telling a Muslim that you're going to remove his balls and see if he doesn't take his business elsewhere.

Fuck privatized health care.
posted by gman at 2:47 PM on March 17, 2010 [4 favorites]

etc. However, in the popular (mis)conception, he is

a. insane
b. envied/jealousy-inducing (have you seen his wife? I mean, really)
c. not to be taken seriously because he's a vegan, likes peace, is from Cleveland, whatever.

I'm pretty far-left by US standards, and you know what? I can't stand Kucinich. This is the guy who opposed the SCHIP bill because it wasn't exactly what he wanted. Did I agree with what he wanted? Heck yeah. But he's incredibly eager to let the perfect be the enemy of the good, and oppose progress on the grounds that it's not everything we've ever wanted. He gives idealism a bad name, because he's made it the enemy of pragmatism and the search for real solutions.
posted by Tomorrowful at 2:48 PM on March 17, 2010 [5 favorites]

So, I don't see the problem here; I mean, if what they're doing is illegal, surely the policyholder just has to tell the insurance company they're doing something illegal, and they'll reinstate the policy. If not, a simple call to your lawyer should get things moving. It's really up to the (ex-)policyholder to know the laws and their rights, and force the insurance companies to behave within the boundaries of the law. If the (ex-)policyholder can't do something as simple as that, they don't deserve to have insurance anyway.

epic-super-HAMBURGER
posted by davejay at 2:49 PM on March 17, 2010 [1 favorite]

Fuckers
posted by hillabeans at 2:51 PM on March 17, 2010

Joe Beese: Kirkpatrick also acknowledged that White House Deputy Chief of Staff Jim Messina had confirmed the existence of the deal to him.

You have heard about the big row recently within the administration where it finally came to light that Rahm Emmanual has essentially been going behind his boss's back, making "practical political compromises" and badmouthing his boss for being too idealistic and naive about how politics work and about America being a center-right country, right?

I wouldn't put a whole lot of stock in anything coming from the chief of staff's office right now.
posted by saulgoodman at 2:52 PM on March 17, 2010

This American Life did a segment on rescission last year (episode here, and the segment starts in the streamed version around 35:20), where they talked a lot about health insurance companies revoking policies just when people need them the most.

It's just heartbreaking that this continues to happen.
posted by joan cusack the second at 2:52 PM on March 17, 2010

Well it would have cost them a lot of money to pay for his treatment! Like an insurance company would do! But we don't have health insurance! We have basically a system of brokerage for healthcare! Dollar-based rationing if you like! It's fucking horseshit to call this insurance at this point!
posted by Mister_A at 2:53 PM on March 17, 2010 [2 favorites]

It's only going to get worse if we give in on a less than GREAT solution

It will take 30 years to get what you are talking about. Meanwhile, they'll be thousands of preventable deaths. thousands.

The perfect should not be the enemy of the good.
posted by Ironmouth at 2:54 PM on March 17, 2010 [8 favorites]

You know, now that's we've recognized that corporations have all the same rights as people, I can't help but ask myself how we put a corporation in jail. Do you just arrest everyone employed by the corporation? Just the shareholders? The board of directors?

Lawsuits are all well and good, but this practice deserves a criminal trial.
posted by Joey Michaels at 2:56 PM on March 17, 2010 [7 favorites]

But Tomorrowful, can't you at least agree with his general premise behind such action, which is that it takes a hell of a lot more effort to get a bad law off the books than it does to retrench and rework as needed? How many ridiculously bad bills have made it through because no one bothers to read the fine print? At least he does read the fine print -- as he (in)famously did on the Patriot Act when no one else seemed to want to bother.

Nothing is EVER going to be perfect, but if there are fundamental flaws that need to be addressed, they should be addressed, not "oh, we'll get to that later"-ed.

It should also be said that with the Cleveland Clinic and other major, major hospital/medical business being a HUGE moneymaker here in his district, that every time he opens his mouth on this bill, he is risking massive blowback from one of the largest corporations (and employers) in town. Who else does that? No one. You don't see Lieberman (oh, I hate that guy...sorry to keep using him as an example, but it's a good one here) talking smack about insurance, one of the biggest employers in his state, do you?
posted by bitter-girl.com at 2:57 PM on March 17, 2010 [2 favorites]

The perfect should not be the enemy of the good.

And, indeed, good should not be the enemy of "still shitty, but not as quite as fucking awful."
posted by Joey Michaels at 2:57 PM on March 17, 2010 [2 favorites]

The perfect should not be the enemy of the good.

If the rising cost of health care is any indication, forcing people to subscribe to private insurance without any cost controls is more like a discussion about middling to bad, as opposed to from perfect to good. Trolling by the Teabagger Party aside, there are legitimate reasons for thinking this is not even a decent direction to go in, let alone best.
posted by Blazecock Pileon at 3:02 PM on March 17, 2010 [1 favorite]

I wouldn't put a whole lot of stock in anything coming from the chief of staff's office right now.

Except that in this case the chief lobbyist for the hospital industry has also confirmed the deal. It sure looks legit that Obama promised no public option to hospitals while he was talking out the side of his mouth about the importance of the public option to anyone who asked him about it.
posted by mediareport at 3:02 PM on March 17, 2010 [2 favorites]

More here on how Rahm Emanual has been deliberately cutting deals behind President Obama's back and openly mocking the administration and its loyalists for their political idealism and convictions.

Oh, man, I hope he goes soon. It drives me crazy when people talk about this clown like he's some kind of evil genius. Rahm Emanuel is an idiot; there hasn't been a more oversold political figure since Bobby fucking Jindal was going to save the Republican Party. Emanuel actually thinks — as per the latest NYT magazine piece — that he's going to be mayor of Chicago. He has no fucking idea what the hell is going on.
posted by enn at 3:03 PM on March 17, 2010 [3 favorites]

Trolling by the Teabagger Party aside, there are legitimate reasons for thinking this is not even a decent direction to go in, let alone best.

The guy in this very fpp might disagree with you.

And there will be cost controls: Rate increases will be subject to review under the new law.
posted by saulgoodman at 3:04 PM on March 17, 2010

And, saulgoodman, the hospital industry deal is classic Rahm-style corporate Dem bullshit. That HuffPo post nails it here:

More deeply, there are serious questions about the extent to which Obama, with the help of Rahm Emanuel, used a K Street strategy to pursue health care reform. The strategy seems to have been to make backroom deals to protect the interests of the likes of the drug industry and the for-profit hospital industry in exchange for campaign cash, even if this meant reversing campaign promises to include a public option to put competitive pressure on private insurance premiums, and to allow Medicare to negotiate for lower drug prices and Americans to buy cheaper drugs from Canada. The result is a health care bill that is generally unpopular with voters.
posted by mediareport at 3:05 PM on March 17, 2010 [1 favorite]

Except that in this case the chief lobbyist for the hospital industry has also confirmed the deal.

Yes. As a deal he made with the chief of staff.
posted by saulgoodman at 3:05 PM on March 17, 2010 [1 favorite]

Emanual has since been working behind Obama's back to foil support for the public option among congressional Dems--that's the whole point.
posted by saulgoodman at 3:06 PM on March 17, 2010

You know, now that's we've recognized that corporations have all the same rights as people, I can't help but ask myself how we put a corporation in jail.

Arthur Anderson was the first corporation criminally charged. And it stuck. They pled out.
posted by Ironmouth at 3:07 PM on March 17, 2010

saulgoodman, if that stuff is true about Emanual, how come he still has a job?
posted by vibrotronica at 3:08 PM on March 17, 2010

Ironmouth: It will take 30 years to get what you are talking about. Meanwhile, they'll be thousands of preventable deaths. thousands.

We've been working on national health coverage since the 1930s, for heaven's sake! It took 30+ years to get Medicare in place alone, and the mechanisms by which it finally did get passed were slightly on the shady side, if you believe its opponents. And so, given that the Democrats are going to get the full colonoscopy-no-lube-on-the-scope from the Republicans and those batty teabaggers on anything they want to pass, let alone something big like this, we'd be well advised to make sure everything is on the up and up. I'm not saying let's take another 30 years, I'm saying make sure it's bulletproof so we don't end up shooting ourselves in the foot. Not perfect, but not full of the kinds of holes that are going to end up backfiring. We've got a chance to finally do it right, let's do it right.

Blazecock Pileon: If the rising cost of health care is any indication, forcing people to subscribe to private insurance without any cost controls is more like a discussion about middling to bad, as opposed to from perfect to good.

Also this.
posted by bitter-girl.com at 3:09 PM on March 17, 2010 [2 favorites]

saulgoodman: "More here on how Rahm Emanual has been deliberately cutting deals behind President Obama's back and openly mocking the administration and its loyalists for their political idealism and convictions."

Yes, it's a shame that Obama doesn't have any way of removing Rahm from the position where he's done so much harm.
posted by Joe Beese at 3:09 PM on March 17, 2010 [3 favorites]

God, you guys are really screwed, aintcha? No socialized medicine, and when you purchase private cover they revoke it on the slightest pretense. Mongrel bastards, the lot of 'em.
posted by turgid dahlia at 3:14 PM on March 17, 2010 [4 favorites]

More importantly, saul, you should be able to point to something concrete - anything concrete - Obama's been doing to pressure Congress to include a public option in health care reform.

Don't waste your time. What he's been doing for months is nothing, aside from sending Rahm over to berate progressives in Congress while bending over backwards to make deals with Republicans and conservative Democrats. You're really arguing this was all done without Obama's knowledge? Ok, then tell us what he *has* been doing while Rahm was worming away behind his back.

Answer: Nothing.
posted by mediareport at 3:21 PM on March 17, 2010 [1 favorite]

If the rising cost of health care is any indication, forcing people to subscribe to private insurance without any cost controls is more like a discussion about middling to bad, as opposed to from perfect to good.

Uh, you do know that the mandate is a cost-reducer, right? Its about having more people in the pool. Basic math there.

but the whole bill is filled with cost reducers? Haven't you read it? (Warning pdf summary).

Sec. 2713. Coverage of preventive health services. Requires all plans to cover preventive services and immunizations recommended by the U.S. Preventive Services Task Force and the CDC, certain child preventive services recommended by the Health Resources and Services Administration (HRSA), and women’s preventive care and screening recommended by HRSA, without any cost-sharing.

Sec. 2718. Bringing down the cost of health care coverage. Health insurance companies will be required to report publicly the percentage of total premium revenue that is expended on clinical services, and quality rather than administrative costs. Health insurance companies will be required to refund each enrollee by the amount by which premium revenue expended by the health insurer for non-claims costs exceeds 20 percent in the group market and 25 percent in the individual market. The requirement to provide a refund expires on December 31, 2013, but the requirement to report percentages continues.

Sec. 1003. Ensuring that consumers get value for their dollars. For plan years beginning in 2010, the Secretary and States will establish a process for the annual review of increases in premiums for health insurance coverage. Requires States to make recommendations to their Exchanges about whether health insurance issuers should be excluded from participation in the Exchanges based on unjustified premium increases. Provides $250 million in funding to States from 2010 until 2014 to assist States in reviewing and, if appropriate under State law, approving premium increases for health insurance coverage and in providing information and recommendations to the Secretary.

Sec. 1103. Immediate information that allows consumers to identify affordable coverage options. Establishes an Internet portal for beneficiaries to easily access affordable and comprehensive coverage options. This information will include eligibility, availability, premium rates, cost sharing, and the percentage of total premium revenues spent on health care, rather than administrative expenses, by the issuer.
Sec. 1104. Administrative simplification. Accelerates HHS adoption of uniform standards and operating rules for the electronic transactions that occur between providers and health plans that are governed under the Health Insurance Portability and Accountability Act (such as benefit eligibility verification, prior authorization and electronic funds transfer payments). Establishes a process to regularly update the standards and operating rules for electronic transactions and requires health plans to certify compliance or face financial penalties collected by the Treasury Secretary. The goal of this section is to make the health system more efficient by reducing the clerical burden on providers, patients, and health plans.

Sec. 1311. Affordable choices of health benefit plans. Requires the Secretary to award grants, available until 2015, to States for planning and establishment of American Health Benefit Exchanges. By 2014, requires States to establish an American Health Benefit Exchange that facilitates the purchase of qualified health plans and includes a SHOP Exchange for small businesses. Requires the Secretary to:
7
 Establish certification criteria for qualified health plans, requiring such plans to meet marketing requirements, ensure a sufficient choice of providers, include essential community providers in their networks, be accredited on quality, implement a quality improvement strategy, use a uniform enrollment form, present plan information in a standard format, and provide data on quality measures.
 Develop a rating system for qualified health plans, including information on enrollee satisfaction, and a model template for an Exchange’s Internet portal.
 Determine an initial and annual open enrollment period, as well as special enrollment periods for certain circumstances.

Allows States to require benefits in addition to essential health benefits, but States must defray the cost of such additional benefits. Requires Exchanges to certify qualified health plans, operate a toll-free hotline and Internet website, rate qualified health plans, present plan options in a standard format, inform individuals of eligibility for Medicaid and CHIP, provide an electronic calculator to calculate plan costs, and grant certifications of exemption from the individual responsibility requirement. Beginning in 2015, requires Exchanges to be self-sustaining and allows them to charge assessments or user fees. Allows Exchanges to certify qualified health plans if they meet certification criteria and offering them is in the interests of individuals and employers. Allows regional or interstate Exchanges if the States agree to, and the Secretary approves, such Exchanges. Requires Exchanges to award grants to Navigators that educate the public about qualified health plans, distribute information on enrollment and tax credits, facilitate enrollment, and provide referrals on grievances, complaints, or questions.

That's the tip of the ice berg.
posted by Ironmouth at 3:21 PM on March 17, 2010

Ironmouth: Rep. Kucinich is a true left-leaning Democrat. Blue Dogs are conservative DINOS (Democrats In Name Only); they really ought to grow a pair and just call themselves the Republicans that they act like. What really gets me is that feeding the insurance companies, even through a Public Option, is just utter bullcrap. Insurance companies exist to make money (this is called capitalism), not to help pay for whatever large expenses anyone may have. If there is ANY way an insurance company can get out of paying out, they WILL. Why can't Single Payer, or, god forbid, socialized health care be discussed? I, for one, am planning on gladly paying a penalty to the government annually because I will not choose an insurance provider. Call it an act of patriotism, because it'll be helping to pay off the national debt (chuckle).
posted by frodisaur at 3:21 PM on March 17, 2010 [1 favorite]

This happened to us. During a physical therapy session, my wife mentioned to the PT that we were thinking about getting pregnant and asked if there were any precautions we'd have to take. One week later Blue Cross dropped our coverage due to fraud without any further explanation. We spent several months fighting to get a reason: eventually they said we falsified our initial application and neglected to include all pre-existing conditions. We showed them the section of the form where we had, in fact, included that information, but they simply sent notice that their position hadn't changed.

We met with several lawyers, but to a person they said that although our case was pretty much open and shut, there were no damages: the only thing we could sue for would be reinstatement of coverage and Blue Cross would be free to immediately drop us for some other reason. Of course, we could get "lucky" and find ourselves deathly ill during the suit, but until the case was settled we'd have to pay all costs out of pocket, and that wasn't going to happen. One lawyer sent a nastygram on our behalf, but Blue Cross stood firm.

Today we pay over $1,500 a month for coverage with a stack of riders. Our total health care costs have topped $20,000 for each of the past four years. We've just hit the wall this month and will probably shed coverage in the coming weeks.
posted by eamondaly at 3:27 PM on March 17, 2010 [14 favorites]

I can't stand Kucinich. This is the guy who opposed the SCHIP bill because it wasn't exactly what he wanted.

I rather like Kucinich and his beliefs, but I agree with your sentiment completely. Stuff like the SCHIP vote is basically Ron Paul in reverse.

That being said, his vote really matters this time, and I'm glad that he's articulated his concerns and decided to vote for the bill anyway...
posted by rollbiz at 3:29 PM on March 17, 2010

Fuck the world, I am going to curl up in bed with a cup of hot chocolate and a kitten.
posted by desjardins at 3:29 PM on March 17, 2010 [7 favorites]

In fact, TWO kittens. So there.
posted by desjardins at 3:30 PM on March 17, 2010 [10 favorites]

Ironmouth: Uh, you do know that the mandate is a cost-reducer, right? Its about having more people in the pool. Basic math there.

I think you need to work on your math too. It's not a cost reducer, it's a cost spreader.
posted by Malor at 3:31 PM on March 17, 2010

I have 2 kittens, a dachshund and a bottle of Southern Tier Creme Brulee Stout I have been saving for months, desjardins. Hand me the remote, will you?
posted by bitter-girl.com at 3:33 PM on March 17, 2010 [2 favorites]

Ironmouth: "Uh, you do know that the mandate is a cost-reducer, right? "

Apparently, not as much as they thought.

... AFL-CIO President Richard Trumka is on his way to the White House to discuss plans by Democrats to actually raise the tax on middle class health care plans in order to pay for the bill. ...

Frankly, this is what unions get for accepting the excise tax in the first place. They agreed to the health care tax – a Reagan idea – and so of course they should expect it to be raised. I just don’t think they thought it’d be raised before they even pass the bill.
posted by Joe Beese at 3:37 PM on March 17, 2010

Uh, you do know that the mandate is a cost-reducer, right? Its about having more people in the pool. Basic math there.

Please explain why an insurer wouldn't take advantage of its newfound government-enforced monopoly (in the many states with only one viable insurer) to raise prices to the maximum allowed under the law (which is going to be much more than many people are currently paying).
posted by enn at 3:42 PM on March 17, 2010 [1 favorite]

Does the bill include provisions to force insurance companies to grant coverage?

My understanding is that the legislation under discussion forces community rating and the taking of all comers. So you can't be singled out for a higher rate, and you can't be denied on your health history. It's actually hard to imagine what recision even looks like under that situation: what ostensible grounds could the insurers use to drop you? Mostly the bill looks like good news to me on that front.

Of course, I'm not totally sanguine. The system will still be such that once you become a net liability, insurers have an incentive to dump you. And if they're not allowed to dump you, they might be able to get away with making your experience bad enough that you get fed up and want to try some other insurer. That's the class of abuses I predict will come out of this eventually. I don't know yet if it'll be industry wide and if there's a proposed way of checking it.

So, I don't see the problem here; I mean, if what they're doing is illegal, surely the policyholder just has to tell the insurance company they're doing something illegal, and they'll reinstate the policy.

The problem with this is that bringing the mechanism of the legal system to bear on the insurance company in order to get them to comply takes time, skill, and money. If you're already suffering from a chronic or catastrophic health condition, you are quite likely to not only be short of some or all of the above, but to be facing an adversary that makes being stocked up on all of the above part of its daily business. It would be a David vs Goliath fight if you were well.
posted by weston at 3:50 PM on March 17, 2010 [3 favorites]

More importantly, saul, you should be able to point to something concrete - anything concrete - Obama's been doing to pressure Congress to include a public option in health care reform.

You guys always talk about this "pressure." I work in this town. How does this "pressure" work? Because you never have votes or answers on these questions. There are always just assumptions that it could be done, never telling people how.

Because the reality is that these guys get to make up their own minds. So you have to persuade, to deal and wheel. Why do you think this is so easy? FDR, Truman and Johnson couldn't do it. Neither could JFK. What's your plan?
posted by Ironmouth at 3:53 PM on March 17, 2010

Please explain why an insurer wouldn't take advantage of its newfound government-enforced monopoly (in the many states with only one viable insurer) to raise prices to the maximum allowed under the law (which is going to be much more than many people are currently paying).

Please cite your money figures.
posted by Ironmouth at 3:54 PM on March 17, 2010

I think you need to work on your math too. It's not a cost reducer, it's a cost spreader.

Resulting in a lower cost for many americans. The more people in the pool, the lower the overall cost. Admin costs are lower with economies of scale. How else do you pay for the outlawing of recission and pre-existing condition bars? How else?
posted by Ironmouth at 3:56 PM on March 17, 2010

I can't stand Kucinich. This is the guy who opposed the SCHIP bill because it wasn't exactly what he wanted.

I rather like Kucinich and his beliefs, but I agree with your sentiment completely. Stuff like the SCHIP vote is basically Ron Paul in reverse.

That being said, his vote really matters this time, and I'm glad that he's articulated his concerns and decided to vote for the bill anyway...

Amen to all that.
posted by Ironmouth at 3:58 PM on March 17, 2010

Why can't Single Payer, or, god forbid, socialized health care be discussed?

Because it doesn't have the votes. There aren't enough votes for it in either house. This is academic. If you can get the votes I'm on board. But the fools (like John fucking Stewart, who is getting terrible of late) think that somehow you bullshit your way into negotiating with people by insisting that single payer is the starting point. You do no good that way. Everyone knows it is a dead letter, so making it your "starting point" just looks like bullshit posturing and weakness.

I negotiate a fair amount of settlements. You don't help yourself by just making shit up.
posted by Ironmouth at 4:01 PM on March 17, 2010

Uh, you do know that the mandate is a cost-reducer, right? Its about having more people in the pool. Basic math there.

Your calculation is based on the assumption that health insurance companies will have an incentive to reduce prices, even when their customer base is assured by law.

There is no legal obligation to reduce prices, and the insurance companies have a captive market, with no public option to provide competition. It's one reason why patented drugs are so expensive, for example, and why there is opposition to and lobbyist intervention in bulk purchases of prescription medicines by state and local governments. While these purchases reduce prices for everyday folks, they cut into profits.

Under the new bill, insurance companies will preserve existing market arrangements — they will maintain their monopolies within the states they are licensed to operate. One of the threats made to insurance companies by President Obama was to revoke the government's protection of existing local monopolies. It was never followed up on.

In a larger sense, if corporations could operate with basic, honest math, I suspect we wouldn't have had to give handouts to Wall Street bankers. I don't see private health insurers willing to do the basic math you're describing, when they will come up with smaller profits, as a result.

For these reasons, I do not agree that the mandate will be a cost-reducer on the basis of "more people in the pool".
posted by Blazecock Pileon at 4:02 PM on March 17, 2010 [2 favorites]

Please cite your money figures.

OK. In the Senate bill, "No penalty [for failure to comply with individual mandate] if the cost of cheapest available plan exceeds 8 percent of household income." I'll find a source saying that a lot of people pay less than 8% of their income in premiums if you insist but it seems fairly self-evident to me.
posted by enn at 4:02 PM on March 17, 2010

Seriously, saul, your argument that Obama is somehow unaware of and not responsible for his own administration's lack of any serious interest in a public option because he's had the wool pulled over his eyes by Rahm is beyond belief.

Nice way to distort what I said. I didn't argue anything; I just pointed out that there is currently a fairly major scandal in Washington about the role Rahm Emanual has been playing in brazenly attempting to undermine the policy positions of President Obama (like the unauthorized side deal Emanual was caught trying to cut with Lindsey Graham about trying the Guantanamo detainees in the military tribunal system). This is a current, unfolding situation within the administration, with even the likes of Michael Moore chiming in, offering himself up as Emanual's replacement.

Joe Beese: In fact, they are currently discussing how to give Emanual the boot, but given how effectively Emanual knows how to work the system (and as has been noted the WaPo seems to be his best friend and fiercest protector).

I like how you shift between Obama and his administration vaguely and seamlessly, conveniently ignoring the whole point of this recent scandal is recent revelations that finally fingerprint Emanual as the source of many (if not all) of these sort of shady press leaks about deals within the administration.

The debate currently underway is what to do about Rahm, because he enjoys tremendous popular support among the old guard Dems and Clintonistas (and even a lot of misguided progressives, who mistakenly see him as some kind of progressive anti-Rove).

But it's his own words that give him away--in particular, his remarks about how President Obama and his most loyal advisors just don't get that America is essentially a center-right country--exactly the same old garbage we used to hear under the Clinton administration.
posted by saulgoodman at 4:04 PM on March 17, 2010

As previously stated in this thread. FUCKERS.

As a product of the National Health Service, I have started to embrace my newfound pinko Communist status in every conversation I have here in Texas. I figure if I belabour some of these teabaggers over the head with a hammer and/or sickle enough it might just knock some sense into their heads.
posted by arcticseal at 4:16 PM on March 17, 2010 [1 favorite]

Your calculation is based on the assumption that health insurance companies will have an incentive to reduce prices, even when their customer base is assured by law.

Insurance companies have some incentives to reduce prices even under our current crappy system -- this is one of the few things customers can judge them on, since valuable information on coverage quality or likelihood of recision or other abuse isn't readily available.

This incentive will actually be magnified if the "must take all comers" rule ends up meaning that coverage is totally portable -- if you can leave an insurer at any time and choose another one. I hear that may not be the case, though... specifically it sounds like going between employer-sponsored group coverage and exchange coverage may not be allowed. Still, even if it's only available between individual plans on the exchange, that's something.

the insurance companies have a captive market, with no public option to provide competition

The insurance industry will have a captive market. Individual companies will have no guarantee of enrollees and will have to compete for them.

Or they'll have to compete on having the healthiest class of enrollees. I suspect some companies will go this route.
posted by weston at 4:20 PM on March 17, 2010 [2 favorites]

I negotiate a fair amount of settlements. You don't help yourself by just making shit up.

Yes, but you do help yourself by bluffing, as the DINOs/Blue Dogs et al seem to have amply proved. Or, to use myself as an example: when I was in the middle of pretrial stuff...

(suing a largish suburb and their insurance company for negligence that caused a pretty nasty physical injury -- when I won, my health insurance company was able to come after me to get paid back in full...yes, you pay all your premiums, but if you actually do get hurt and manage to win a lawsuit about it, the insurance company can ask to be PAID BACK IN FULL for everything they expended on your behalf -- what a racket! get paid premiums for years, pay out on a small fraction of them, and get some of that money back, too!)

...the judge on the case said to the city's lawyer and insurance company's lawyer (or so I am told): "Are you insane? Have you seen her scars? You need to settle right now and stop wasting the court's time, because if you don't, a jury's going to give her a million bucks. Do you want that? Do you?"

They'd bluffed right up until that point, when she brought it all home. In the healthcare debate, Ben Nelson turned around and started whistling when he got called out on his bullshit. (Now it's the "Cornhusker Kickoff" instead of "Fuck y'all, fuck all y'all, Nebraska wants to get PAID"). Etcetera, etcetera. There's nothing wrong in using single payer as a starting point.

Yes, it's academic.
Yes, it's unlikely to get passed. We don't value our citizens the way other civilized nations do.

But it doesn't mean you ignore it and put your fingers in your ears and go LA LA LA LA LA LA LA PEOPLE MIGHT VOTE ME OUT IF I SAY 'SINGLE PAYER' OUT LOUD...you see what good ideas you can get from it, and use it to make the bill you CAN pass better. Say single payer controls admin costs nicely. Ok, how? What can we do in our bill that incorporates similar efficiencies? And so on... This is why the bill is neither perfect nor good -- everyone's so damn afraid to examine all the possibilities and what we can learn from them that it's crippled from the start.
posted by bitter-girl.com at 4:21 PM on March 17, 2010 [2 favorites]

The thing that amazes me is how Obama sucks Republican dick every chance he gets, and yet, when it comes to voting for healthcare reform, he got... Z E R O votes from the Republicans.

So if the opposition is 100% against your proposals even though you've watered them down to the point of homeopathy, and now you must rely exclusively on your own side... well, doesn't that say, that you should now go with the maximum proposal? I mean it's not like the Republicans can vote more than 100% against you. If you gotta do all the fighting anyway, may as well go whole hog - you can't get the Republicans any madder than they already are.

Here's what you do. You go for the maximum - single payer and all. Make your case to the American people, get the entire administration onboard and on message. Have it voted down by a combo of Repubs and Blue Dogs. Go to the American people and say: the healthcare reform has been voted down by: roll call of votes that killed it. "If you want healthcare that will not bankrupt you, your family or the country, please get us a congress that will pass healthcare reform. In the meanwhile, every time you lose coverage, or go bankrupt or cannot afford basic care - please remember what needs to be done." And then, every single time an insurance company raises rates - as they did by up to 39% recently in California - go on TV and say: "here's another reason why we need to reform healthcare - please send us a congress that can get it done" - drip, drip, drip, drip. Here's what's certain: insurance costs will keep going up - thus providing a steady stream of education opportunities, which must be exploited relentlessly, until it becomes an established truth... a technique the Repubs have been using to get their lies traction. Time to get the discussion on our terms. Tell the voters - your choice is to keep going bankrupt and without care, or put pressure on your representatives to pass the bill. The MAXIMUM bill. Not the watered down shit that gets nobody excited and bribes no Repubs.

It's time to go to war.
posted by VikingSword at 4:35 PM on March 17, 2010 [12 favorites]

The insurance industry will have a captive market. Individual companies will have no guarantee of enrollees and will have to compete for them.

If that were true, the only place to go is down, competition-wise, and there would already be a significant level of price and feature flexibility in the current private insurance offerings. As of now, I only have access to one of two plans, both of which force the consumer to bear significant costs, and that's through my employer. If I attempt to get personal insurance on my own, I'll pay more than what I pay now (with my employer and I both "contributing" a percentage of my work compensation).

I have no legitimate alternatives, as do nearly every person I know. The meager options and high prices do not prove active collusion, but I do not experience any of the downstream benefits of competition that should be here and now, in a supposedly free market. Just imagine how it will be a few years from now as individual companies keep merging and experience increasingly less pressure to compete.

Perhaps a large antitrust lawsuit (or a series of show trials, god forbid) will be coming in 20-30 years, once the current crop of Supreme Court justices are dead and buried and their rulings are gradually undone. Of course, President Obama could have headed most of this off from the start, simply by mandating a public option alternative and cost controls.
posted by Blazecock Pileon at 4:48 PM on March 17, 2010

But saul, that still comes back to the same point: if Obama doesn't have the sack to even sack the dude who's [allegedly] going behind his back and undermining his administration's centerpiece goal... then Obama is as useless and incompetent as his former fans believe.

No, the point is they likely are going to sack Emanual, despite the fact that doing so will come at a high political cost. Emanual has a lot of clout both with the press and congressional Dems, and it's not especially clear who a suitable replacement would be. And the timing would be lousy--it would distract from and probably derail the effort to get the reforms in their current form through, setting the whole process back to zero.

Virtually everyone (particularly in the punditocracy) was all gung-ho about having a so-called enforcer like Emanual working on the admin's behalf. No one once considered what might happen if Emanual turned out to be a loose cannon.

Anyway, it's a derail.

The point on topic is that rescission will no longer be allowed under the law. Whether or not insurance companies find clever ways around the law in some cases, that's a major step in the right direction, and it explicitly affirms that the insured have a right to expect that their policies won't be dropped simply because their claims are too costly (currently, believe it or not, it's perfectly acceptable to drop expensive consumers).

Here's what you do. You go for the maximum - single payer and all. Make your case to the American people, get the entire administration onboard and on message. Have it voted down by a combo of Repubs and Blue Dogs. Go to the American people and say: the healthcare reform has been voted down by: roll call of votes that killed it. "If you want healthcare that will not bankrupt you, your family or the country, please get us a congress that will pass healthcare reform.

Really? You think that would fly with an electorate that allowed themselves to be convinced to the tune of something like 30% of the population that the pending watered-down legislation amounted to a government health care take over that would have created death panels for killing off seniors? An electorate who voted in a tea party, anti-tax candidate to show their outrage over congress not pushing harder for a public option?

No. Way. The American electorate is far too susceptible to spin and to divide and conquer coalition-busting tactics for your approach to amount to anything more than a pipe dream. In a lot of ways, the approach you're suggesting is exactly the same approach Clinton took with health care (although with less ambitious proposals). And it failed miserably.
posted by saulgoodman at 5:07 PM on March 17, 2010 [1 favorite]

The thing that amazes me is how Obama sucks Republican dick every chance he gets, and yet, when it comes to voting for healthcare reform, he got... Z E R O votes from the Republicans.

There is a lot of truth to this, crudeness aside, and on a lot of subjects too. This seems to be a Dem problem in general, this idea of "maybe if I just give in on X, they'll like me". THEY'RE NEVER GOING TO LIKE YOU, DUDE. Eric Cantor, Michelle Bachmann Overdrive, et al are building their careers solely on their opposition to you.

This sort of compromise stands to gain Obama nothing from the opposition, and demoralize supporters. I thought he might've had it right, finally, after the healthcare summit. I have no problem with letting the conservatives air out their "ideas" in public, because their ideas are silly when they exist at all. But for fuck's sake, don't start pretending that shit like tort reform is the solution to the healthcare crisis, BO!

I keep waiting for the genius to emerge from the cocoon of the capitulator...and waiting...
posted by rollbiz at 5:10 PM on March 17, 2010 [11 favorites]

In fact, TWO kittens.

Could you send your spare over here?
posted by marxchivist at 5:18 PM on March 17, 2010 [1 favorite]

Really? You think that would fly with an electorate that allowed themselves to be convinced to the tune of something like 30% of the population that the pending watered-down legislation amounted to a government health care take over that would have created death panels for killing off seniors? An electorate who voted in a tea party, anti-tax candidate to show their outrage over congress not pushing harder for a public option?

Love it. One word question: HOW? To expand: how did "the electorate allow themselves to be convinced"? Exactly. That's why Democrats keep losing. Because they are shrinking, mumbling, mealy-mouthed spineless scarridy cats, while Repubs are on message, non-stop, repetitious and relentless. It's tactics. The Dems have the better product - the Repubs have the better sales team. There is ZERO excuse to lose the sale when you have a better product.

So, "the electorate allowed themselves to be convinced"? Great. Convince them then! Especially that your product is a lot more attractive.

Take no prisoners. Get everyone on message - constituent complains about health care in any way? Advise them to call their Republican or Blue Dog representative and demand help. Every single blessed time. One of two things will happen - either the Repub/BD knuckles under after a few hundred thousand calls, or gets voted out. We don't care. We know the healthcare situation will continue to get worse - what we have to do is to assign blame to its rightful place - R/BD. Relentlessly. It'll take time, but it'll work. It's war - if you don't win, you perish. And the strategic forces are our favor - the healthcare situation is getting ever more dire... now exploit it without mercy.
posted by VikingSword at 5:20 PM on March 17, 2010 [6 favorites]

Heh. You guys really think politicians are in some kind of adversarial relationship with the insurance companies?
posted by telstar at 5:24 PM on March 17, 2010

The real point of the summit, rollbiz, was to show the Republicans had no genuine interest in compromise to make it harder for them to reopen the issue when, in the worst-case scenario in November, the Republicans sweep congress (elected by people angry that HCR didn't go far enough) proclaiming loudly (and being echoed endlessly by every major media outlet in the country) that they were elected on a wave of populist opposition to "government-run health care."
posted by saulgoodman at 5:26 PM on March 17, 2010

If it wasn't clear, saulgoodman, I totally understand that. It's what happened afterwards that I don't understand.
posted by rollbiz at 5:35 PM on March 17, 2010

So, "the electorate allowed themselves to be convinced"? Great. Convince them then! Especially that your product is a lot more attractive.

The American electorate--even if it knew what it wanted--doesn't know how to manipulate its political system half as well as its political system knows how to manipulate it.

You will never get the kind of unity you're imaging on any major issue in this country so long as we remain neatly segmented into rabid social and ideological groupings that mistrust and despise each other.

As long as big business interests that are radically hostile to progressive reform have more influence over the mainstream media than ordinary citizens or even the US government (excepting the military establishment, which in many cases actually is the media establishment, too), and as long as people remain susceptible to the old "repeat a lie often enough" gimmick, it's completely unrealistic to expect that you will ever achieve an overwhelming popular consensus on any subject in the modern world (short of some dramatic event--like, say a major terrorist attack).
posted by saulgoodman at 5:37 PM on March 17, 2010 [1 favorite]

"THEY'RE NEVER GOING TO LIKE YOU, DUDE."

Truer words have never been spoken. Ten points to rollbiz.
posted by bitter-girl.com at 5:51 PM on March 17, 2010 [2 favorites]

Saulgoodman, it is only impossible if it's just one side that's fighting - the Repubs, with the Dems constantly on the defensive. I disagree that it's impossible to get the American people behind a given program. It's not. I don't want to Godwin, but mass psychology has been studied, and you yourself cite the "repeat a lie often enough"... which is what the Repubs are doing. Fine. But what's good for the goose is good for the gander. You can "repeat the truth often enough" - and that's exactly what the Dems have not been doing. They need to learn to simplify, distill, and then have the discipline to relentlessly stay on message. It'll take some time before they are as good at it as the Repubs, but they'll get there - and they do have the better product. Plus the forces are aligned in their favor - things are getting worse.

Obama must go on the offensive. Go into the lions den - to a Southern state which you have no hope of winning (so you have nothing to lose) - like Alabama, and tour, give speeches pointing out how people are living like shit compared to a lot of the rest of the country and how the insurance companies are raping them, and ask if they like it. Because unless they decide to vote differently, it'll only get worse. Make them aware of the price they are paying. And then, one day, when the only place you can get bread from to feed your family is by turning to the Devil (voting for a Demo), you'll be shocked by how many people will abandon their previous position and go for the Devil. You just must make the choices clear. It may take a couple of election cycles, but you'll eventually get movement. Make people pay for how they vote. Don't gloss over the consequences - and don't be above pointing it out, relentlessly.
posted by VikingSword at 5:51 PM on March 17, 2010 [2 favorites]

This is so bad, I wonder when we'll see the movie about this?

And on that note, I wonder if the settlement included a provision that "you won't sell publicity rights about this case."
posted by Cool Papa Bell at 5:53 PM on March 17, 2010

If it wasn't clear, saulgoodman, I totally understand that. It's what happened afterwards that I don't understand.

They did the math. There weren't enough votes in the senate for the public option. And there still aren't. Pushing too hard to include provisions at this stage with the potential to torpedo the possibility of passing the reform package through reconciliation would have rightly been criticized on all sides as a boneheaded move if they had done it. Why not demand that congress take some political risks for a change?

The Republican strategy from day one has clearly been to use suspicions about Obama's being a secret radical communist to fight the reform effort, while also deliberately working to cast President Obama personally in the role of lightning rod for political outrage to give "moderate" and conservative Dems political cover in their home states; if the president had come out in support of including the public option through reconciliation at this point, it would have sparked a firestorm of right-wing paranoia about President Obama ramming his policies down the American people's throats. As it is, they're still trying to push that absurd line as far as it will go, and getting insane amounts of traction in a lot of quarters.

Every single one of you who believes the President didn't push hard enough or go far enough has a doppelganger over on FreeRepublic who believes Obama is a dangerous proto-dictator, relentlessly pursuing a radical socialist agenda. Obviously, there's no consistent reality in which both of you are right. But guess what? That fact doesn't necessarily imply that either of you is right, either.

Saulgoodman, it is only impossible if it's just one side that's fighting - the Repubs, with the Dems constantly on the defensive. I disagree that it's impossible to get the American people behind a given program. It's not. I don't want to Godwin, but mass psychology has been studied, and you yourself cite the "repeat a lie often enough"... which is what the Repubs are doing. Fine. But what's good for the goose is good for the gander. You can "repeat the truth often enough" - and that's exactly what the Dems have not been doing.

Every single time the Dems have tried to get ahead of the press game, the press' default position is to report the controversy. When the Republicans start a press push, the press reports the republican talking points; when the Dems start a press push, the press reports the controversy, and explicitly includes the Republican counter talking points. It's up to the media outlets to provide balance to the coverage, and they don't. The last story I heard on HCR on NPR gave over 20 minutes to Republican legislators critical of the reform effort, and that's been the typical pattern for coverage throughout the entire process. Even when Obama played a trump card and went directly to the public to promote HCR, the coverage on NPR mainly focused on opinion polls showing that a majority of people resented the intrusion into their TV schedules.

How can the Dems get a message out when the only messenger in town is essentially on the Republican payroll?
posted by saulgoodman at 6:07 PM on March 17, 2010 [3 favorites]

Here's the main difference I see between Democrats and Republicans. Dems are thoughtful, have a range of views and debate actual policy nitty-gritty. Repubs have one-liners meant for TV and have purity tests. Sure, you might 'lose' a few news cycles, but why would you give up the former in favour of the latter? Doesn't anyone like good-faith debates anymore?
posted by the cydonian at 6:16 PM on March 17, 2010

Saulgoodman, we're going in circles, and I don't want to repeat myself, so I'll say this, and leave it at that: in essence you're saying the Democrats can't win because of the press! That's silly. I have no love for the failures of our fourth estate, but I don't worry that they are "not on our side". Let them report the Repubs responses. I'll gladly take them on. I'll give my side, they give theirs. And I hope that I'm competent enough, my product is good enough and the situation dire enough, so that my points strike clear as a bell, and the Repub points sound stupid and people make their choices.

This is crazy - the Dems should be winning this fight by a country mile. But as long as they are on the defensive, and afraid of short-term losses, they'll lose. Sacrifice an election cycle or two if need be, but stay on message - and you'll come out ahead. Fight, and take no prisoners... because we've seen how the other way works out.
posted by VikingSword at 6:16 PM on March 17, 2010 [1 favorite]

Every single one of you who believes the President didn't push hard enough or go far enough

That's the thing though, I'm not even saying this. What I'm saying is that he had it right in letting conservatives tell the American public just how ridiculous or non-existent their ideas are, but he has it very, very wrong with giving ground to them on things like tort reform, which consequences aside would provide 2 point something percent savings at best in the face of 10-15% cost increases. How many Republican votes did recent concessions like this get him, vs. how many disillusioned supporters he created?

I don't see the win in that, is all I'm saying.
posted by rollbiz at 6:17 PM on March 17, 2010

but he has it very, very wrong with giving ground to them on things like tort reform, which consequences aside would provide 2 point something percent savings at best in the face of 10-15% cost increases

I'm not sure where your numbers come from, but I don't really understand your disillusionment about including some limited tort reform. We actually could use some tort reform, whether Republicans suggested it or not. It's a fair point. The post-summit compromises were mostly pretty decent policy. And they significantly upped the threshold for what constitutes a "Cadillac" health plan (which was a compromise the Senate included that had to be reconciled with the house bill somehow). Just because the idea came from Republicans doesn't mean they were bad policy. And the latest indications are that the Stupak amendment is out of the picture now, so the administration's efforts to push back in that area seem to have paid off (the policy in the compromise bill is still not ideal on abortion, IMO, but at least, it's not worse than it was before).
posted by saulgoodman at 6:31 PM on March 17, 2010

Michelle Bachmann Overdrive

Five thumbs up to rollbiz.

Here's the main difference I see between Democrats and Republicans. Dems are thoughtful, have a range of views and debate actual policy nitty-gritty. Repubs have one-liners meant for TV and have purity tests.

If you're talking about Congress, they're mostly (mostly) legitimized whores (whether for an insurance company, a mining company, the teachers' union, their own fame, etc), no matter their party affiliation.
posted by sallybrown at 6:36 PM on March 17, 2010

Well, first of all, my tort reform number comes from the CBO, who estimated the savings at $54 billion over 10 years. They actually estimate the heathcare cost savings percentage much lower than I did, at 0.5 percent. I was drawing my other numbers from research I did on this a few months ago.

I'm not disillusioned with the concept, actually, I don't hate tort reform. I really hate the argument from the right that tort reform is the answer to rising healthcare costs though, due to the numbers I just cited, and I think that Obama was tacitly agreeing to that when he decided to argue it as a serious element of reform to placate the Republicans.
posted by rollbiz at 6:41 PM on March 17, 2010

Saulgoodman, we're going in circles, and I don't want to repeat myself, so I'll say this, and leave it at that: in essence you're saying the Democrats can't win because of the press! That's silly.

You're right that we could go around and round on this point, so I'll just say this last piece on it. It's the public that can't win because of the press. The press is a machine for furthering business interests now, and that's basically all that's left of it, as far as I can tell.

Don't tell me we've already forgotten how obvious it became where the press' allegiances lay during the Bush administration? In the aftermath of the Judith Miller affair? Sure, they've all since issued their feeble mea culpas, but did anyone lose their jobs (apart from Miller)? Did I just imagine the NY Times went on to hire Bill Kristol as a columnist after that (sure, he's left since then, but the message couldn't have been clearer at the time)? Did I just imagine that Karl Rove went on to a gig as an analyst for Fox News, the network with the highest rated news programming in the country? It's still a very lopsided picture of reality the public gets these days, that's all I'm saying.
posted by saulgoodman at 6:53 PM on March 17, 2010 [2 favorites]

I think that Obama was tacitly agreeing to that when he decided to argue it as a serious element of reform to placate the Republicans

I think he was demonstrating a willingness--in contrast to the Republicans themselves--to take any constructive idea seriously no matter where it came from, without letting partisanship enter into consideration of the idea itself. If the Republicans are wrong to dismiss good Democratic proposals on purely partisan grounds, how is it not an appropriate corrective to be genuinely willing to include any good ideas Republicans contribute to the process? If he had rejected the suggestions for no reason other than the personal satisfaction that comes from sticking it to an adversary, he would have been doing exactly the same thing we criticize the Republicans for.
posted by saulgoodman at 7:01 PM on March 17, 2010

Babblesort: "Fuck that. Knowingly failing to deliver on contracted insurance that will result in death from AIDS is either negligent homocide or murder and it should be prosecuted as such. I'm sick of this crap."

Quick! Call Jack McCoy!

Kidding aside, totally agree with you, Babblesort.
posted by bwg at 7:06 PM on March 17, 2010

I don't disagree that good ideas should be taken wherever they come from. However, when tort reform was rolled up with the others that he was considering due to the summit, it was pretty clear to me that he was looking to win some Republicans over by incorporating their ideas, and in doing so he forgot that their main idea is "NO!", currently. The Republicans have also been offering tort reform as a primary solution, so if he's not looking to placate this delusion he needs to be loud and clear about the fact that it's a piece of the pie, or not even a piece so much as the tiny crumble that fell off onto the table.

To derail a bit in order to express another example of my concern, look at the situation surrounding the Khalid Sheikh Mohammed trial.
posted by rollbiz at 7:09 PM on March 17, 2010

You guys always talk about this "pressure." I work in this town. How does this "pressure" work? Because you never have votes or answers on these questions. There are always just assumptions that it could be done, never telling people how.

You keep repeating this sentiment in health care threads, even though it is false on its face. You mean to say that there's literally no way for an American political party to get its members to stick together for a simple procedural vote? You want an example of pressure? It took one plane ride with the President to change head liberal Dennis Kucinich's mind. Some kind of pressure was brought to bear.

if the president had come out in support of including the public option through reconciliation at this point, it would have sparked a firestorm of right-wing paranoia about President Obama ramming his policies down the American people's throats

Good thing that didn't happen.

Every single one of you who believes the President didn't push hard enough or go far enough has a doppelganger over on FreeRepublic who believes Obama is a dangerous proto-dictator, relentlessly pursuing a radical socialist agenda. Obviously, there's no consistent reality in which both of you are right. But guess what? That fact doesn't necessarily imply that either of you is right, either.

I believe the Democrats in general and Harry Reid in particular have demonstrated tactical incompetence. This is not some kind of crazy or radical conspiracy idea. It's an observation of the last 14 months of miscues, cowardice and idiocy. People need to lose their jobs over this debacle. Start with the PR people and the political consultants and maybe we'll have a chance to save some kind of majority in November. But Reid needs to go, one way or the other. He's sucked for four years, and the last year is the icing on the cake. For the good of the party, he should face a no-confidence vote ASAP.
posted by vibrotronica at 7:11 PM on March 17, 2010 [5 favorites]

I was all in favor of Single Payer, or a Public Option.

That is, until I saw that commercial on the teevee where they loudly and emphatically proclaim "If you have medicare or medicaid we will get you a free rascal scooter!!!! If your medicare won't pay for it, it's on us!"

Maybe other countries can handle socialized medicine, but here in the US of A it's just a matter of time before "healthcare for all" turns into Late night infomercials for NFL licensed artificial hips.
posted by billyfleetwood at 7:25 PM on March 17, 2010

Hooray for living in Australia!!!!
posted by bramoire at 7:56 PM on March 17, 2010

I believe the Democrats in general and Harry Reid in particular have demonstrated tactical incompetence

I don't dispute that. In fact, I'll go farther and say a lot of it was deliberate--because the establishment in Washington in general is center-right. Electing Obama didn't change that. But what happens to health care or any other reforms when the Republicans sweep the elections in November (which they might)?

The last time we had a Republican congress and a Democrat in the White House, congress spent nearly the entire time relentlessly trying to impeach the President. Do you think it's going to be a prettier picture when we send a new crop of Tea Party Republicans (many of whom question even President Obama's citizenship) to congress? Wait and see. We'll do exactly what we do every time we aren't getting what we want from congress: vote out all the incumbents to "send a message to Washington," setting the progress bar right back to zero again in the process.

You want an example of pressure? It took one plane ride with the President to change head liberal Dennis Kucinich's mind. Some kind of pressure was brought to bear.

Do you think this would have worked on Lieberman? Cause it's guys like Lieberman and Nelson--guys who don't particularly care about advancing a progressive platform at all--that we've got to contend with. And no, there's no real mechanism other than promising to help or hurt with fundraising that has much influence in Washington anymore. The party can threaten to remove someone from a committee or whatever, but they can't just kick them out for not voting the party line. Sucks, I know, but that's American democracy for you.

And as long as Obama polls poorly in the moderate/conservative states, the congressmen from those states don't have a reason in the world to give one iota of a damn about what Obama wants them to do, because his support could actually hinder their fundraising efforts. Kucinich responded positively to Obama's appeal because Kucinich is a rare animal in Washington: a principled politician, who can be persuaded to take a position based on the merits of policy, rather than strictly triangulating the politics. Congressmen--and senators particularly--are not the fungible chess pawns you make them out to be.
posted by saulgoodman at 8:00 PM on March 17, 2010 [2 favorites]

I wonder how Obama's supporters reconcile their impression of him as an intelligent Ivy League graduate and once-in-a-generation political talent with their conviction that he is, at least at present, under the thumb of his employee Rahm Emanuel.

I mean, saulgoodman, as I understand you, you are saying that the man Obama handpicked for his powerful position is now returning the favor by ass-fucking him in the media. And, at least until the forces are amassed to strike back, Obama is just standing there taking it.

That would seem to make having picked Rahm a pretty fucking stupid mistake, would it not?

But of course there is alternative theory. One that has the charm of simplicity, if nothing else...

Rahm - serving at the pleasure of the President, as they say - is doing exactly what Obama wants him to do.

If there is any evidence to contradict that theory - other than one's belief in Obama's fundamental niftiness - I welcome its presentation.
posted by Joe Beese at 8:02 PM on March 17, 2010 [2 favorites]

And as long as Obama polls poorly in the moderate/conservative states

saul, the public option polls positively across the US. Why is he not fighting for it?
posted by mediareport at 8:20 PM on March 17, 2010

as I understand you, you are saying that the man Obama handpicked for his powerful position is now returning the favor by ass-fucking him in the media. And, at least until the forces are amassed to strike back, Obama is just standing there taking it.

I'm not saying it; others who closely watch this stuff are. Refer to the links I included above.

For the record, no one actually said Rahm Emanual was buggering the president. Just that he seems to be deliberately undermining his agenda, and has recently been very openly critical of the president for being too unrealistic in his expectations about how much change can actually be achieved.

So basically, Rahm Emanual's complaints about the president are that he's too progressive and too reluctant to make the kinds of backroom deals Emanual thinks are necessary to get the job done. And yet, people hold up Emanual as the exemplar of the tough partisan political fighter in Washington.

So what does that tell you about where Obama's commitments actually lie relative to the rest of the Washington establishment? You complain that he compromises too much, or that he's not a sincere reform advocate, but the consummate Washington insider that the punditocracy almost universally applauded as a strong choice for the role of chief of staff when the decision was made, complains of exactly the opposite and accuses the administration of being too committed to progressive ideals?

And firing the Chief of Staff of an organization like the White House can't just be done at the drop of a hat. The chief of staff position is important. Someone has to be found to fill the slot first; it would be irresponsible not to have a replacement and would bring normal operations to a halt otherwise. Also, firing him requires building political pressure so that congressional Dems don't revolt. This shit isn't half as simple or straightforward in real life as it is in your imagination, Joe, but god bless you.
posted by saulgoodman at 8:25 PM on March 17, 2010

Exactly, Joe Beese- either Obama is the most witlessly manipulated president since, well, the last one, or Emanual is just following orders (of which potentially being the 'troublemaker' scapegoat is just one more task)....
posted by hincandenza at 8:32 PM on March 17, 2010 [2 favorites]

saul, the public option polls positively across the US. Why is he not fighting for it?

National polls don't matter. What matters is how Obama polls in the specific districts of the congress critters that need to be persuaded to vote for the legislation, and the level of antipathy there is toward the public option on the part of the individual legislator.

How does the public option poll in Nebraska, home to Ben Nelson? Turns out not so well. So why should a senator facing reelection in that state support it? (Oh and guess what? Turns out support for the public option tracks closely to support for Obama, so whether you're convinced or not on the point, much of the public seems to think of the public option as Obama's baby. Funny how the only people I hear complaining about Obama not having come out clearly enough in support of the public option all along are people who identify as supporters of the public option; among people who don't support it, it's apparently considered a commonsense reality that Obama and the public option are one and the same).
posted by saulgoodman at 8:36 PM on March 17, 2010

Exactly, Joe Beese- either Obama is the most witlessly manipulated president since, well, the last one, or Emanual is just following orders (of which potentially being the 'troublemaker' scapegoat is just one more task)....

All right that's just some really lame, intentionally nasty ego-baiting you're doing there, and it obviously isn't meant to persuade me of anything other than your own determination not to consider alternatives to your established beliefs, and to annoy me, so goodbye.
posted by saulgoodman at 8:48 PM on March 17, 2010

saulgoodman: "So basically, Rahm Emanual's complaints about the president are that he's too progressive and too reluctant to make the kinds of backroom deals Emanual thinks are necessary to get the job done."

Did he specify which of Obama's decisions were too progressive?

Was it indefinite imprisonment without trial?

Or was it Presidential assassination of American citizens?

But seriously, do you have a single shred of evidence that Obama is even slightly displeased with Rahm - let alone looking to replace him?
posted by Joe Beese at 8:50 PM on March 17, 2010

... if the president had come out in support of including the public option through reconciliation at this point, it would have sparked a firestorm of right-wing paranoia about President Obama ramming his policies down the American people's throats

Good thing that didn't happen.

The votes were there for passing the public option (at least) through the Senate in reconciliation. The Dems didn't do it because the White House said it would undermine the message of bipartisanship

Obama reminds me of a boss with a hands-off approach. He's giving everyone a chance to do their jobs without Bush-style micromanagement. His highly public exasperation with the health care debate seems to indicate his realization that without constant pressure Congress doesn't work. I expect that in another year or two he'll start signing executive orders and tell Congress to go fuck itself. Constant pressure isn't his style.

You want an example of pressure? It took one plane ride with the President to change head liberal Dennis Kucinich's mind. Some kind of pressure was brought to bear.

Do you think this would have worked on Lieberman? Cause it's guys like Lieberman and Nelson--guys who don't particularly care about advancing a progressive platform at all--that we've got to contend with. And no, there's no real mechanism other than promising to help or hurt with fundraising that has much influence in Washington anymore.

What kind of pressure you ask? How about "Nelson, toe the line or I'll close every military base in your state and pull every Federal dollar out with them." How about "Joe, if you don't shut up and vote for this I'll fill your district with EPA inspectors. They'll be sure to find something to shut down." And that's just off the top of my head. I'm sure Michael Moore could do better.
posted by irisclara at 9:41 PM on March 17, 2010 [1 favorite]

I think when he's much older and can look at all the facts with the magnificent benefit of hindsight, he'll be grateful he didn't face an NHS death panel though.

/sarcasm
posted by MuffinMan at 9:43 PM on March 17, 2010

Okay, I'm rescinding my flame out. But I am (dammit) finally going to ignore the Obama derail.

One last thing, at least on the topic of health care: Robert Reich on "Health Care 2010 and 1994, and the Political Lessons of History."

What happened to Jerome Mitchell should never happen to anyone in America again. And if this legislation passes, and we hold our elected officials feet to the fire at the national and local levels to ensure that the provisions banning rescission are given teeth, maybe it really won't.

But you have to understand, it won't be at the national level alone that the real effectiveness of these policies is determined. It will be at the state level, at the local level, at the level of implementation and enforcement.

Just bitching about Washington--even getting the best reforms in the world on the books if it worked--won't come even close to finishing the job.

Laws need societies actively upholding them to have any force. And it's still going to be at the street-level, where the rubber hits the road, that these laws achieve their intended effects or not. That's part of the reason Republicans are already rallying the troops around the idea of boycotting or otherwise refusing to comply with the new health care laws once they go into effect. If the laws fail to achieve their aims in implementation, even if they're perfectly constructed as law, they fail all the same, and the Republicans will come out looking to some people like geniuses, rather than the opportunistic, obstructionist little weasels they actually are.
posted by saulgoodman at 9:43 PM on March 17, 2010

What kind of pressure you ask? How about "Nelson, toe the line or I'll close every military base in your state and pull every Federal dollar out with them.

(Sigh...)

...Which voters in Nebraska (who, remember, don't support the public option by a substantial majority), are going to blame on Nelson, instead of the guy who ordered all their bases closed and took all their federal money as political retribution for Nelson's voting the way his constituents expressly wanted him to for what reason again? (And the president is authorized to unilaterally stop all federal funding to Nebraska under what constitutional authority again? He can propose budgets, but congress gets the final say. He can't just do an end run around the process, as far as I know.)

Your scenario keeps Nelson in office, and turns Nebraska (and maybe me, for that matter) against Obama in the next election. How does that get us closer to the goal again?

Next.
posted by saulgoodman at 9:53 PM on March 17, 2010

... turns Nebraska (and maybe me, for that matter) against Obama in the next election.

How can you lose what you never had.
posted by irisclara at 11:35 PM on March 17, 2010 [2 favorites]

It's yet another appalling story, and yet another story that makes the case for a decent, fair healthcare system in the US.

But .... if it isn't going to happen now, with BarryO, with the majority that he has (although many of the Democrats seem spineless), it won't happen.

And if it won't happen now, it won't happen until the US is completely and utterly broken, down on it's knees, and has nothing less to lose. "why not try decent healthcare, we're fked anyway?"

From an outside's pov, it's as if the US has got one sick foot, and is deciding to get a shotgun and blow a hole in the other one rather than fix the sick foot.

Unreal.
posted by rolandroland at 2:41 AM on March 18, 2010

What kind of pressure you ask? How about "Nelson, toe the line or I'll close every military base in your state and pull every Federal dollar out with them."

That would be about as effective as pressure as threatening "Nelson, toe the line or I will use my wizardly powers to turn you into a newt."
posted by ROU_Xenophobe at 7:58 AM on March 18, 2010

From saul's link to Robert Reich's article above:

On February 5, 1994, the National Association of Manufacturers passed a resolution declaring its opposition to the Clinton plan. Not long after that, Michigan Democrat John Dingell, who was managing the health care bill for the House, approached the senior House Republican on the bill to seek a compromise. According to Dingell, the response was: "There's no way you're going to get a single vote on this [Republican] side of the aisle. You will not only not get a vote here, but we've been instructed that if we participate in that undertaking at all, those of us who do will lose our seniority and will not be ranking minority members within the Republican Party."

That is how you apply pressure to a Senator.
posted by vibrotronica at 8:55 AM on March 18, 2010 [3 favorites]

From Holding Out To Whipping Health Care -- How Dennis Kucinich Is Helping Dems Pass Reform

Dennis is now lobbying other holdouts to follow him.
posted by octothorpe at 9:44 AM on March 18, 2010

That is how you apply pressure to a Senator.

That is how you apply pressure to a member of the house, not to a senator like Ben Nelson, because seniority in the senate is determined by state population as derived from the census, not by the whims of senate party leadership.

Without a rule change (which can only be made when a new Senate convenes for the first time), you can't just arbitrarily strip away seniority in the senate. It's set according to state population and other, predetermined factors like years served and previous political positions held.

Also that may be how you apply pressure NOT to do something to a member of the house. But that approach still doesn't necessarily work if your aim is to get them to actually do something politically contentious.

Besides, Ben Nelson doesn't have much seniority to start with. He's ranked 58th in the senate out of 100. And Nelson doesn't hold any committee chairs.

So again, what do you suggest?
posted by saulgoodman at 11:17 AM on March 18, 2010

who the fuck was evil enough to write the algorithm? kafkaesque fucking bastards COCKDRIZZLE
The only way to ever post anything on the internet is with an excess of swearing
/outragefilter
posted by yoHighness at 12:11 PM on March 18, 2010

On February 5, 1994, the National Association of Manufacturers passed a resolution declaring its opposition to the Clinton plan. Not long after that, Michigan Democrat John Dingell, who was managing the health care bill for the House, approached the senior House Republican on the bill to seek a compromise. According to Dingell, the response was: "There's no way you're going to get a single vote on this [Republican] side of the aisle. You will not only not get a vote here, but we've been instructed that if we participate in that undertaking at all, those of us who do will lose our seniority and will not be ranking minority members within the Republican Party."

You can only do that to a few. Because you do enough and they vote you out as speaker.
posted by Ironmouth at 2:27 PM on March 18, 2010

... turns Nebraska (and maybe me, for that matter) against Obama in the next election.

How can you lose what you never had.

Obama got one of the Nebraska EVs, I think.
posted by Ironmouth at 2:27 PM on March 18, 2010

So again, what do you suggest?

If the Senator cannot see his way clear to vote for a bill, that's one thing. If a Senator will vote against his party in what should be a simple procedural matter and prevent something as important as health care reform from even coming up to a vote, then I see no reason that the party should continue to give support to that Senator in his next re-election campaign. I see no reason why the leadership should cooperate with such a Senator in any manner whatsoever.

And for the one millionth time, Joe Lieberman should be immediately removed from his Homeland Security chairmanship. The motherfucker doesn't even self-identify as a Democrat any more.
posted by vibrotronica at 7:36 PM on March 18, 2010 [1 favorite]

If the Senator cannot see his way clear to vote for a bill, that's one thing. If a Senator will vote against his party in what should be a simple procedural matter and prevent something as important as health care reform from even coming up to a vote, then I see no reason that the party should continue to give support to that Senator in his next re-election campaign. I see no reason why the leadership should cooperate with such a Senator in any manner whatsoever.

I agree. Consider, though, how the national Democratic party is structured. It's kind of complicated. There are a lot of different players involved in calling the shots. Virtually every leadership decision is made by committee. If you've ever sat on a committee, you understand how that usually goes. And presumably, the makeup of the committees more or less mirrors the makeup of the congress, with plenty of "moderates" and Washington veterans in the mix.
posted by saulgoodman at 8:45 PM on March 18, 2010

More here on how Rahm Emanual has been deliberately cutting deals behind President Obama's back and openly mocking the administration and its loyalists for their political idealism and convictions.
posted by saulgoodman at 6:00 PM on March 17 [+] [!]

Dude has zero sourcing for that article. Doesn't even say anything on who told him that.
posted by Ironmouth at 9:21 AM on March 19, 2010

Fuck the world, I am going to curl up in bed with a cup of hot chocolate and a kitten.

In fact, TWO kittens. So there.

You're going to need a bigger cup.
posted by davejay at 9:29 AM on March 19, 2010

Conservatives Pile On 11-Year-Old Whose Mother Died Without Health Insurance.

Tea Party Protesters Berate Apparent Parkinson's Victim (w/video).
posted by ericb at 10:59 AM on March 19, 2010

Allen Boyd no to yes? Wow. If we got that fucker, we got it made. He's the worst of the Blue Dogs.
posted by Ironmouth at 1:11 PM on March 19, 2010

Two college student's mini documentary: The Tea Party & The Circus - Final Healthcare Reform Protest.
posted by ericb at 1:32 PM on March 19, 2010

* students' *
posted by ericb at 1:39 PM on March 19, 2010

More here on how Rahm Emanual has been deliberately cutting deals behind President Obama's back

The thought just occurred, when I revisited the thread, that that could be a form of 'good cop, bad cop'. In this case, perhaps Rahm is being the 'bad cop', and trying to appeal to the base motives of other bad cops, rolling his eyes at 'good cop' Obama to gain credibility... but still doing his bidding. Obama might know exactly what's going on there.

Of course, that's presupposing that it's even true, and so far it's just a rumor.
posted by Malor at 9:30 PM on March 19, 2010

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