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Blue Dogs Don't Want a Public Option That Works

July 10, 2009 - by Donny Shaw

I had been looking forward to today’s planned unveiling of the House’s health care reform bill. We’ve already seen drafts, but with the Democratic leadership saying they intend to get a bill passed through the House before the August recess, it’s about time the public sees the bill, which is expected to be around 1,000 pages long and constitute the most significant change to our health care system in decades.

But the unveiling of the final bill has been delayed because of some last-minute concerns from 40 conservative Democrats from the Blue Dog Caucus. The conservative Democrats sent a letter last night to the leadership expressing their “strong reservations” about the bill and said that they “cannot support a final product that fails to” address their concerns. Knowing that they need a certain level of Blue Dog support to get the bill through the House, the Democratic leadership was forced to take things back to the drawing board for some adjustments and now plan to introduce the final bill sometime next week.

A lot of what the Blue Dogs are asking for in the letter seems, to me, workable and reasonable – small-business protections, deficit-neutrality, rural health equity, bipartisanship, etc. But tucked in toward the end of the letter is a startling paragraph explaining their problems with the Democrats’ plan to create a “Medicare-like” public health care option to compete with private insurers. In the letter they write:

In order to establish a level playing field, providers must be fairly reimbursed at negotiated rates and their participation must be voluntary. A “Medicare-like” public option would negatively impact hospitals, doctors and patients. Medicare reimbursement is on average 20 to 30 percent lower than private plans and this inequality is even greater in some parts of the country. Using Medicare’s below-market rates would seriously weaken the financial stability of our local hospitals and doctors.

Two things about this:

1) The Blue Dogs pride themselves on being “fiscal conservatives,” yet here they are arguing that the government should actually spend more money than they have to for the exact same level of care; and

2) The statement suggests that they are missing the whole point of the public option. If the government is able to spend less and still be competitive, it will encourage private insurers to reduce their own costs and increase their efficiency so they can compete.

Here’s how Chris Bowers at Open Left puts it:

Many of the Blue Dogs are simply not intellectually honest. Some others are not even really that intellectual, given how often they contradict themselves and repeat lobbyist talking points verbatim.

If they were smart and intellectually honest, you might be able to point out to them it is impossible to start lowering the cost of health insurance unless some entity begins selling lower priced health insurance. The Blue Dog argument is that we can just keep paying everyone in the health care industry the same amount of money, and that somehow prices will go down anyway. That doesn’t make any sense, but try explaining that to them.

At this point, I can’t imagine what the solution is here. Would rank-and-file and progressive Democrats still support a bill with a public option that pays reimbursments on parity with private insurers? What would be the point? Being able to tell their constituents they helped support a winning compromise on the public option even though it won’t actually have a meaningful impact on bringing down costs?

Or, maybe some Blue Dogs will change their minds and start agreeing with Blue Dog Rep. Loretta Sanchez [D, CA-47] “who believes that we should be required to have a public option because it will bring the costs of health care down.”

UPDATE: Looks like Sanchez has some friends. The Hill is reporting that a “band of House centrists” has sent a letter to the leadership expressing their support for a “robust” (aka “Medicare-like”) public option:

A band of 22 New Democrat and Blue Dog lawmakers say they support a “robust” government-run health plan, boosting chances of moving healthcare reform with a public insurance plan through the House.

Democratic centrists remain the biggest obstacle to House Speaker Nancy Pelosi’s (D-Calif.) ability to pass a healthcare bill with a public plan, and many conservative Democrats oppose a public option as unfair to private insurers.

But the letter from the 22 New Dems and Blue Dogs indicates opposition from this group is far from universal.

“We have a broader coalition to pass this than what was assumed before,” said Rep. Lois Capps (Calif.), a New Democrat who circulated the letter supporting a public option with Rep. Chris Murphy (D-Conn.). “While we may belong to a more moderate branch, we want it known that we support the public option.”

The 20 New Democrats on the letter represent nearly one-third of the 68-member caucus. It is signed by two Blue Dogs and three members who are both New Dems and Blue Dogs.
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  • Wallysmom 07/10/2009 5:49pm

    Any Blue Dog Democrat (and most Republicans, too) who do not vote for this bill WITH a public option are ignoring the desires of their constituents. They are chosing to vote based on their own personal beliefs or ignorance of need and should not be re-elected. The people want this option.

  • Comm_reply
    Anonymous 07/11/2009 7:37am

    You are wrong my friend. The people DON’T want the public option. We already have a public option. It’s called Medicare and Medicaid. Obama’s administration talks about 46 million Americans who don’t have insurance. Lets break it down. 10 million are illegal. If they want insurance then they need to put some skin in the game (become American citizens and pay taxes). Another 10 million can get insurance but choose not to. They are the young 18 to 30 year-olds. Finally, there are countless millions who are qualified to receive some form of medicare or medicaid but haven’t signed up. So that leaves about 20+ million that need insurance but can’t get it. The solution is to setup an insurance exchange (much like the one Mitt Romney setup in Massachusetts) that lets people shop for “private” health insurance just like we can for car insurance.

  • Comm_reply
    Anonymous 07/11/2009 8:37pm

    Sorry, YOU are wrong:

    “A clear majority of Americans — 72 percent — support a government-sponsored health care plan to compete with private insurers, a new CBS News/New York Times poll finds. Most also think the government would do a better job than private industry at keeping down costs and believe that the government should guarantee health care for all Americans.”

    72 percent. They must not live in the “real America”.

  • Comm_reply
    Anonymous 07/12/2009 1:06pm

    That poll is dated; 6/20/09! The public opinion has changed considerably since then. Especially since the democrats are considering raising our taxes to pay for this massive government takeover. This would be breaking a campaign promise Obama made during his campaign of no increase in taxes.

  • Comm_reply
    usmarbws2005 07/13/2009 6:51am

    Hi Anonymous,

    First of all that is a CBS poll, which has a very left wing audience majority. Wait to see some type of gallop poll release rather than using a CBS poll so you can be sure that what you are reading is accurate. I don’t know why you are using the “Most” to represent most of us citizens, but I believe you are now brain washed or close to it by the hateful, liberal, socialist, and communist media and it’s constant inaccuracy and pro-left bandwagon views. Government caused the housing crisis and can’t keep track of it’s own money and spending along with passing 1300 page bills that are not given a chance to be read due to the “Urgency” of the crisis. If anyone thinks that the government is in anyway capable of providing health care in a cost effective, efficient way, they have been living in a movie dreamland.

  • Comm_reply
    Anonymous 07/13/2009 9:13am

    Right! That awful, inefficient, government-run health insurance that the private insurers won’t be able compete with because people… uhh, won’t want it… because it’s bad, but but but, it’s going to put all the private insurers out of business, because noone will want it… hmmmm.

    What is it fellas? It either sucks and noone will want it, or it works and will compete with the private sector. You can’t have it both ways. But then again, conservatives and logic are strange bed-fellows these days.

    By the way, usmarbws, the poll included 284 Republicans, 301 Democrats and 310 Independents which actually OVER-represents Republican considering how few people actually identify themselves as a Republican these days.

    People want the public option. Deal with it.

  • Comm_reply
    daringone 07/14/2009 2:22am

    The part that you are missing here is that if it does suck and fail, you just pissed away another 1.2 TRILLION DOLLARS of taxpayer money, and that’s just the “getting started money”. So here are the real two options, it sucks and we piss away a bunch more taxpayer money or it is successful and begins killing off public health care, costing yet even more people’s jobs.

    To me, both results sound like failure.

  • Comm_reply
    Anonymous 07/14/2009 9:56am

    Except we already have a public option that a) works and b) people like more than private insurance. It’s called Medicare. The chances of the public option “failing” when such a successful model exists are close to nil.

    Also, you fail to mention the costs of NOT reforming health care, which would far exceed the $1.2 trillion over ten years.

    If the consequence of lower costs and better quality care for more people is less profitable health insurance companies, so be it. Peoples lives and health should not be a for-profit industry.

  • Comm_reply
    martinsanner 07/14/2009 12:15pm

    Here is a left-wing CNN poll posted on July 1st: “A CNN-Opinion Research Corp. survey released July 1 found that a slim majority - 51 percent (NOT 72 PERCENT)- support Obama’s health care plans, but most worry that their costs would go up, and only one in five (20%) thinks their families would be better off”. And once again you are incorrect about people liking Medicare more than private insurance. Where do you get your information? Senior citizens would rather pay for their own insurance rather than joining Medicare because providers do not want Medicare patients because they pay less than what most procedures cost.

  • Anonymous 07/11/2009 3:26am

    There is but one thing driving the Blue Diogs: campaign contributions. They are bought and paid for by the insurance industry and they insist on letting them drain 31% for administration (billing) and overhead (CEO salaries, bonuses and shareholder profits). Get the corrupt campaign contributions out of the system and they’ll fix it overnight.

    Jack Lohman …

  • deborahg6 07/11/2009 5:25am

    Thank you Wallysmom for presuming so much on behalf of “the people”. Many, including myself, do NOT want this option. Funny how the word “option” is even being used. It will most assuredly drive out other private insurance companies (competition? are you serious?) and rationing and higher taxes are just on the horizon. Do you really think “the people” want the government in charge of health care? People are asleep and lulled into the “pacifier in my mouth, Nanny won’t you give me some more, twilight”. Wake up, before it’s too late!

  • Comm_reply
    Anonymous 07/11/2009 7:40am

    I totally agree with you on this…Obama wants to create a nanny nation. A nation of dependents and complacents. It is sickening!

  • AlphaOmega 07/12/2009 1:29pm

    According to the Constitution we are to have a Constitutional Republic but what we are is being converted to COMMUNISM through DEMOCRACY. Some people here and other places had better read history and do it quick. Rome is about to fall! Honestly, we are a mere few steps away from communist purges. Read the preamble of the Constitution….
    “We the people of the United States, in order to form a more perfect union, establish justice, insure domestic tranquility, provide for the common defense, promote the general welfare, and secure the blessings of liberty to ourselves and our posterity, do ordain and establish this Constitution for the United States of America.”
    PROMOTE the general welfare & PROVIDE the general welfare are not the same!

  • deannalee1369 07/13/2009 8:08am

    The New York Democrat’s plan is to tax households that earn at least $350,000 annually is a great idea to pay for the public option health care reform. The medical insurance industry does not want a public option because they fear their customers will choose the public option. They say, “Do you want a government agency between you and your doctor”. Well right now if you have medical insurance there is an accountant and health care managers between you and your doctor. If the public option is paid for by raising taxes for those households that earn more than $350,000 per year is a Great Plan!

  • Comm_reply
    Anonymous 07/13/2009 12:53pm

    So people who earn more than $350,000 should have to pay for everyone’s public health care? The state with outrageous taxes already came up with that? The state which has its businesses scrambling to move out of state due to those taxes? Brilliant. Think of the consequences to such a plan. We have no more rich people, they move out of our country, no one to give to charities, no one to invest and create more jobs, no one to inject capital into our economy. Who will be left with the health care mess? Who will be paying for the fiasco for years to come? The same ones who are paying for the stimulus mess, us. The regular Americans who are struggling already.

  • Comm_reply
    martinsanner 07/14/2009 5:16pm

    I do not understand why you liberal democrats believe that government-run healthcare will work! What makes you think it will work when EVERY government-run program has not worked or has huge unfunded liabilities. Medicare has 36 trillion (that’s with a T) dollars in unfunded liabilities. Unfunded liabilities are debt. Debt in the form of markers deposited in fictional trust funds that will someday have to be paid-off by the taxpaying public. Help me to understand…Why do you think that it will work this time! Hell, Obama is talking about a SECOND stimulus. They couldn’t get that right!

  • sureman123 07/13/2009 8:25am

    this health plan is such a bad idea. If this passes we might as well ordain Obama as the supreme ruler till death and just succumb to communism. between this health bill and cap & trade, free America will be something of a memory!

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