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Harkin and Loebsack support public option in health care reform

by: desmoinesdem

Sat May 02, 2009 at 18:00:00 PM CDT

Congress will begin making important decisions on health care policy very soon. The Senate Finance Committee began drafting a health care bill a few days ago.

I was glad to see two Iowans among the representatives and senators who urged colleagues this week to include a strong public option in any health care reform plan.

After the jump I have more on where Congressman Dave Loebsack and Senator Tom Harkin stand on health care, as well as the benefits of creating a public health insurance option.

UPDATE: Thanks to Populista for reminding me that all Iowa Democrats in Congress (Bruce Braley, Dave Loebsack, Leonard Boswell and Tom Harkin) have signed on to support Health Care for America Now's core principles for health care reform.

desmoinesdem :: Harkin and Loebsack support public option in health care reform

On April 28, four House caucuses sent a joint letter to President Obama and Congressional leaders to make clear that "our support for enacting legislation this year to guarantee affordable health care for all firmly hinges on the inclusion of a robust public health insurance plan like Medicare." Click here to read the press release issued by the Progressive Caucus, the Black Caucus, the Hispanic Caucus, and the Asian Pacific American Caucus. Excerpt:

"The American people are united in declaring that our health care system is broken, and that we need to fix it," said Congresswoman Lynn Woolsey, Co-Chair of the CPC. "With this letter, more than a 100 Members of Congress are sending a message that we share the public's outrage, and that we are committed to confronting this problem and developing a health care system that doesn't leave anyone out. That's why we need to make certain that any final healthcare reform legislation includes the option of a public health insurance plan to ensure that everyone has access to high quality, affordable care."
"For too long, insurance companies have dictated the quality, quantity, and accessibility of healthcare to the American people," said Congressman Mike Honda, Chair of Congressional Asian Pacific American Caucus (CAPAC). "A robust public health insurance plan will ensure true competition with those companies that reap egregious profits, and will present the opportunity to make deep, lasting changes in our healthcare system. A public plan will also provide a framework to eliminate racial and ethnic health disparities in some of the most underserved communities."

Representative Loebsack is the only Iowan in the Progressive Caucus, whose leaders went on record a few weeks ago saying most members of the caucus will not vote for any health care bill that does not contain a public option. Loebsack was less categorical in a statement his office sent me on April 22:

"When it comes to health care, there are many options and solutions on the table. I support a strong public option so that we can increase access to quality, affordable health care," said Congressman Loebsack. "There are too many people drawing arbitrary lines in the sand, and we all need to work together to move the conversation forward. That's why I think forums and talking to my constituents is so vital to crafting a comprehensive healthcare plan."

Loebsack's position is sensible, but I am glad to see the leaders of four caucuses signal that their members will not settle for health care reform like the program that has failed in Massachusetts.

I hope that Congressman Bruce Braley's Populist Caucus will take a similar stand. "Providing affordable, accessible, quality health care to all Americans" is one of the six main goals Braley has set for the caucus. Another Populist Caucus goal is "protecting consumers," and a public health insurance plan would give consumers more protection from the whims of private insurers. Moreover, quite a few founding Populist Caucus members also belong to the Progressive Caucus.

On the other hand, some Populist Caucus members also belong to the New Democrats caucus, which leans toward the pro-corporate position on some issues. That may make it hard for the Populist Caucus to reach consensus on health care. I am seeking comment on this from Braley's office. I would hate to see the Populist Caucus stay on the sidelines during this year's critical health care debate.

A coalition supporting a public option is taking shape in the Senate as well. On Wednesday 16 senators who caucus with Democrats, including Tom Harkin, signed a letter to Senate Health, Education, Labor and Pensions Committee Chairman Edward Kennedy and Senate Finance Committee Chairman Max Baucus:

"As members of key committees and leaders on health care issues, we write to support a public plan option as a core component of this reform," the letter said. "There is no reason to believe that private insurers alone will meet the public purpose of ensuring coverage for all Americans at affordable prices for taxpayers."
A public plan option "would provide competition to the sometimes dysfunctional private insurance market," Sen. Sherrod Brown (D-Ohio), who originated the letter, said on a conference call with reporters Wednesday. [...]
Brown said that even with strong insurance market reforms designed to prevent health plans from denying coverage or charging sky-high premiums to people with preexisting conditions, a public plan remains necessary. "Insurance companies have a reputation of staying one step ahead of the sheriff," he said.
Republicans, along with healthcare and business interests, oppose the public plan option. The contend that the plan will muscle out private insurers by cutting payment rates to medical providers in order to charge lower premiums, and will lead to the federal government dominating the insurance market.

One Democratic senator, Ben Nelson of Nebraska, came out this week against any public option as part of health care reform. Jason Rosenbaum of Health Care for America Now has more on Nelson's talking points and ties to the insurance industry. Fortunately, we don't need Nelson's vote, because President Obama is committed to making health care reform part of the budget reconciliation process (so it cannot be filibustered).

I am glad to see Harkin standing with the Democrats pushing health care reform in the right direction.

Please share any relevant thoughts in this thread.

UPDATE: Moveon.org is holding an "emergency online briefing" about health care reform, featuring Howard Dean:

Emergency Online Briefing with Dr. Dean
Monday, May 4, 9pm Eastern
Hosted on MoveOn.org's web site at:
http://www.moveon.org/drdean/?...
Last time Democrats tried to pass comprehensive healthcare reform, it failed. And it failed in part because the opposition was better organized and spread a bunch of lies that progressives weren't prepared to rebut.
It's up to us to make sure that doesn't happen again. We need all hands on deck, well-armed with the critical information, and motivated to keep the right from blocking real change. Dr. Dean will give us an update and inside look at the battle for real healthcare reform -- and the key actions we'll take to achieve a historic victory.
With an important Senate committee meeting on Tuesday to start shaping legislation, plus the right wing's escalating attacks, this couldn't be more urgent.
I'll be part of the emergency briefing, and I really hope you can join me at this crucial moment. Join us online Monday night at 9pm Eastern -- that's 8pm Central, 7pm Mountain, and 6pm Pacific -- this way everyone in the country can join us at the same time.
CLICK HERE ON MONDAY AT 9PM EASTERN TO JOIN US ONLINE

SECOND UPDATE: As I noted upthread, all Iowa Democrats in Congress (Braley, Loebsack, Boswell and Harkin) have signed on to support Health Care for America Now's core principles for health care reform. I am glad to see some Democrats reminding leadership that a public option is a high priority.

Tags: Congress, House, Senate, Health Care, health care reform, public option, Tom Harkin, Dave Loebsack, Bruce Braley, Progressive Caucus, Populist Caucus, New Democrats, Sherrod Brown, Ben Nelson, Max Baucus, Ted Kennedy, (All Tags)

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Harkin and Loebsack support public option in health care reform | 4 comments

letter (0.00 / 0)

from The Hill:

Brown emphasized that the senators who signed the letter are not threatening to reject a health reform bill that excludes a public plan option.
"We are not saying we will not support this without a public option," he said. "This is not a condition to kill healthcare reform."

I admit that I have not been following closely the past month due to schedule conflicts. My gut tells me there will be no public plan. My question to you - have you seen even a rough sketch for a public plan in any of the proposals or formal discussions involving key players?

The focus will be on financing reform and paygo. I see only two paths to revenue neutrality - 1) VAT 2) phasing out the health benefit tax exclusion.

Orszag has turned the O.M.B. into something of a behavioral-economics think tank. Behaviorists reject the classic economic theory of human beings as ultra-rational self-interested actors and, drawing on psychology, examine the causes of seemingly irrational economic choices, such as not taking advantage of money offered in an employer-provided retirement plan or giving away more money to charity than can be explained by purely selfish motives.
Cass Sunstein, the University of Chicago legal scholar, who is the co-author, with Richard Thaler, of "Nudge," a book about how policymakers can harness insights from behavioral economics, and Jeffrey Liebman, a behavioral economist from Harvard, both work for Orszag.
Last month, Liebman brought three leading behaviorists to the White House to advise Obama's health-care-policy team.

Here is how I think it will go. Naturally, formally phasing out the tax exclusion all at once would be quite controversial (especially since this was a McCain campaign plank) so instead, it'll just be wink-wink de facto. The "bad guys" will be the companies that will announce plans to phase out their group plans. A sweetener may be a small bump in salary, particularly for new hires, but not necessary if the economy continues to drag.

If you're young, getting a few extra dollars while paying next to nothing under an individualized mandate will look just fine. The private insurers will still base premiums on age groups.

On the other end, the closest we'll get to a 'public option' is perhaps dropping Medicare eligibility by a few years. The 50-64 yr old group will still be an important in 2012. The private insurers will be thrilled. This will be coupled with incremental changes to what will be covered under Medicare -- the "conversation" starts with the extreme scenario, end-of-life care.

Once it is accepted that there are certain lives not worth extending, the door is open to more cost controls. If you're wealthy, care will be available.

My view is that the full effects of reform (phase-out of tax exclusion and skimpy Medicare) will be in place by the time the (current) 35-49 group hits Medicare eligibility. We are already weak when it comes to voting strength, and of course, attrition will not help.

Behavioral-economics is essentially marketing research, which tells me a product is already in hand. People like Zeke Emanuel and Cass Sunstein are not running around the WH just to fill up office space.

Last time Democrats tried to pass comprehensive healthcare reform, it failed. And it failed in part because the opposition was better organized and spread a bunch of lies that progressives weren't prepared to rebut.

Who is the opposition? Private insurance has been given a big seat at the table. Republicans? Moderate Democrats? The DNC is headed by Kaine and the party is shutting out challengers to newly-minted "Democrats" like Arlen Specter. That only 16 Democrats signed on to the public option letter is quite telling. How do "progressives" rebut when they are split into two camps, HCAN and PNHP? I am open to all ideas.

plus the right wing's escalating attacks

Bogeyman. The right wing is barely coherent, but after you peel off the rhetoric about "socialized medicine," there is a legitimate discussion to be had, and of course, the right wing is about the last place I'd look for leadership.

The questions on my mind:

1) On models that allocate health care efficiently, along the lines of using FICO to allocate credit or risk modeling in finance, and so on. Where is the demonstration that these models actually allocate equitably instead of maximizing gain for for-profit entities?

2) "You can keep what you currently have." Good marketing, but why should I expect employers to maintain existing plans in the future if we are moving to an individual mandate with national/state risk pools?

3) "Shared responsibility." I see no discussion of real shared responsibility. We seem to understand what a "drag" the elderly are, but what about factors that contribute to poor health/illness? We're good at punishing the smokers, but what about the companies that dump toxic waste into the water supply, just for starters? The anti-regulatory environment is just as much a source of cost, yet not a peep about this.

Before indoor plumbing, we didn't have cities larger than Des Moines today, for a good reason -- breeding ground for disease. If there's any lesson from the NAFTA flu, it's the cost of supporting deregulation! Can't pin this on a smoker or grandma.

/end rant

by: ragbrai08 @ Sun May 03, 2009 at 14:57:39 PM CDT

the four House caucuses (0.00 / 0)

are signaling that they will not be easily rolled. If they don't support a health care reform bill, it won't have enough votes to pass the House (we already know the GOP will be against anything that highly regulates private insurers). They appear to be serious about a public option being a deal-breaker, and Obama appears to be serious about using the budget reconciliation process to get this through the Senate with no opportunity for a filibuster.

I am watching and waiting. I wouldn't say I am overly optimistic, but I am more optimistic than I was two months ago. Obama appears to have learned something from his poor strategy during the stimulus negotiations.

Invite other Iowa political junkies to join us at Bleeding Heartland.

by: desmoinesdem @ Sun May 03, 2009 at 18:28:45 PM CDT

[ Parent ]

isn't the budget reconciliation process (0.00 / 0)

a double-edged sword?

Catching up on the discussion about mortgage cram downs and Durbin's comments about Congress as a wholly-owned subsidiary of the financial sector, I'm not holding my breath on these people as champions of the public interest vs FIRE.

by: ragbrai08 @ Sun May 03, 2009 at 21:14:04 PM CDT

[ Parent ]

there are drawbacks (0.00 / 0)

to using the budget reconciliation process. I do not understand all the details, but I believe that we would have to revisit the issue within four or five years if we did it through reconciliation. It would be much preferable to do it the normal way, but with 60 votes as the threshold for passing any bill in the Senate these days, I can't see any health care bill worth passing having a shot.

I agree with Durbin, but he was talking about a bill that needed 60 votes. If we can do health care reform with 51 votes, we have a better chance at a good bill.

Invite other Iowa political junkies to join us at Bleeding Heartland.

by: desmoinesdem @ Mon May 04, 2009 at 00:53:18 AM CDT

[ Parent ]