One of the country's most prominent union officials is warning that big labor may pull its support from Democrats who don't fight for a government-run insurance plan.
In an interview with the Huffington Post on Saturday, Richard Trumka, the secretary-treasurer and likely next president of the AFL-CIO, said his federation is drawing a line in the sand when it comes to a public option in the health care bill. Lawmakers who don't support the provision, he said, shouldn't take anything for granted.
"We'll look at every one of their votes," Trumka said after his speech at the Netroots Nation convention. "If they're against the Employee Free Choice Act, if they're against health care for that reason, I think it'll be tough for them to get support from working people."
Trumka's remarks were echoed privately by several other labor officials at the convention in Pittsburgh. In particular, the emerging Senate Finance Committee plan - which seems unlikely to contain a public option and could end up taxing pricey health care packages - seems almost guaranteed to incite the unions.
"We'll oppose it," Trumka said, when asked about any bill that ends the tax exemption for employer coverage. "It's actually a stupid concept because if you tax those that have it to pay for those that don't, eventually those that have [benefits] won't. Then who do you ultimately tax?"
Trumka's warning shots come at a time that the AFL-CIO is charting out a more aggressive campaign to target lawmakers who, as one official put it, "take labor's help but don't vote for labor's interests." Part of that process is to hold out the prospect of electoral consequences.
Former DNC Chair, Howard Dean, likewise predicted that Democrats who vote against the public option would have to deal with a primary challenge.
Meanwhile, a group of progressive members of the House of Representatives made it clear on Monday that they will not support a health care bill that doesn't include a government run option for insurance coverage.
The AFL-CIO also intends to campaign against targets within the Republican Party and conservative media. In his speech on Saturday, Trumka called out "the entire cast at Fox News," for perpetuating fear and mistruths about the President's health care agenda. He also called Rush Limbaugh a "loudmouth," and decried the fake-grassroots movements being orchestrated in opposition to Democratic reform.
"We are going to continue to mobilize and counter the lies and the myths that they're trying to create to defeat this," he told the Huffington Post. "The special interests, the pharmaceutical industry, the health care industry are so vested in the current system they'll so anything to keep it this way and we have a job to do there.
"We're also going to keep politicians strong so that they don't listen to the moneymen and continue to erode away or negotiate away a program [so much that it] ultimately becomes useless. Right now, without a public option [reform] becomes useless. It won't change the current system."
But what has been perfectly consistent is the way the press has, again, fallen for a right-wing smear campaign and dressed it up as news. Just as with the Swifties, the press has turned over its summer coverage to a band of agitators spreading misinformation. Five summers ago, the Swift Boat Vets helped hijack the election. They lied about documents, they lied about eyewitness, and they lied about their partisan affiliations and connections. For several crucial weeks during the campaign, journalists turned away from the pile-up of Swift Boat falsehoods and contradictions, rarely daring to call the Swift Boat attack out for what it really was -- a hoax. Too spooked by the GOP Noise Machine and its charge of liberal media bias, the press propped up the Vets as serious men and showered them with attention.
This year, the press has handed over untold hours of free airtime to mini-mob members whose sole purpose seems to be to spread as much fear as possible. (The ones who show up toting guns and Nazi posters make that point rather emphatically.)
Fringe players on the right are making wild accusations that cannot be backed up by fact. The mainstream media response? We must cover the phenomenon daily, even hourly!
So, day after August day, these vacuous health care "debates" are aired on cable television, just as news consumers suffered through night after night of vacuous Swift Boat "debates" five summers ago. In both cases, the press for the most part handed in its referee's whistle and focused its attention on simply reporting the fact-free claims and then getting the Democratic response. (i.e. he said/she said.) It turns out journalists are petrified of calling out right-wing activists as liars, and the other side knows it.
What's amazing is that even a conservative Republican congressman has conceded that the mini-mobs (this summer's news superstars) appear to be completely detached from reality. "You cannot build a movement on something that is not credible,'' Rep. Bob Inglis of South Carolina told the Los Angeles Times after being confronted by belligerent, fact-free protesters who were convinced that as part of health care reform, children would soon be forced to receive swine flu vaccinations. "At town meetings, the hostility went straight through to hysteria,'' said Inglis.
The "town hells" are really just mob rule masquerading as a health care debate, masquerading as direct democracy. Sadly, the news media are hyping both phony story lines. The press is taking the fringe players seriously, even the ones who spend their free time drawing up Obama-is-Hitler posters.
The Wall Street Journal, describing a New Hampshire protester:
[She] held a sign with Mr. Obama's face superimposed on a Nazi storm trooper, a sign, she said, that was made by her chronically ill mother.
[...]
"Adolf Hitler was for exterminating the weak, not just the Jews and stuff, and socialism -- that's what's going to happen."
I'm sorry, but since when are these types of crackpot protesters taken seriously by the American media? I guess I must have missed all the prewar coverage in 2003 when reporters from elite newspapers such as the Journal patiently interviewed radical protesters who showed up outside presidential events with posters featuring Bush's face superimposed over a Nazi storm trooper. I must have missed it when the Journal quoted people at length about how Bush wanted to start killing -- "exterminating" -- Americans.
In 2003, those fringe players (understandably) couldn't get arrested by the press. But the mini-mobs today have been ushered onto the national stage and urged to express their hatred incessantly and preferably in front of television cameras. It's just like when the press showered the lying Swifties with all kinds of attention despite the fact that they could barely keep track of their own laundry list of lies.
Today, the press, for the most part, won't call out the mini-mob supporters as liars or point out that, at times, they are blindingly ignorant about the facts in play. (OK, let's stipulate that many media outlets did debunk Sarah Palin's loony "death panel" claim. But does the press really deserve a pat on the back for completing that obvious task? Isn't that like congratulating your 12-year-old for not wetting the bed at night?) Apparently, journalists feel most comfortable reporting on what the mini-mobs are saying and how they're making life politically uncomfortable for Democrats.
Conservative media figures including Sean Hannity, Rush Limbaugh, Ralph Reed, and Mark Steyn have advanced the GOP talking point that health care cooperatives are, in Hannity's words, "basically the same thing" as the public option "with a new packaging." But mischaracterizing cooperatives as identical to the public option ignores numerous economists who have argued that cooperatives will be less effective than a public option.
Media conservatives advance latest conspiracy: Co-op is public option in disguise
Hannity: "[T]he cooperative plan is basically the same thing with a new packaging." Discussing reports that the Obama administration might support health care cooperatives as an alternative to the public option, Hannity claimed, "I think the cooperative plan is basically the same thing with a new packaging." He then asserted that "this is still going to be government-run health care." [Fox News' Hannity, 8/17/09]
Steyn: Co-op no different than public option. While interviewing columnist Mark Steyn, Hannity asked, "The co-ops. But is a co-op any different than the so-called public option?" Steyn responded, "No, I don't think so, because in the end if you have a government perspective on health care, it leads to rationing." [Hannity, 8/17/09]
Reed: "government-run plan now masquerading as a co-op": Appearing on Hannity, former Christian Coalition of America director and Republican strategist Ralph Reed asserted that "the co-op they're talking about is going to be heavily subsidized by the federal government." He then claimed, "Remember that the public option, the government-run plan now masquerading as a co-op, is going to set rates below market rates. It will be subsidized with your and my tax dollars." [Hannity, 8/17/09]
Limbaugh: "If you're going to try to fool us by thinking you're dumping the public option, well then come up with some name that doesn't reek of liberalism." Discussing co-ops, Limbaugh claimed, "Look, I know liberal lingo when I hear it. A co-op? Yeah, let's go to the farmers market. Let's go to the community garden! What, do they think we're idiots?" He continued:
They said they want to cover the uninsured. We can do that without doing this. They said they want competition, they said. OK, great, we can do that, too. But they want single payer, and they're not going to give up and there's no competition in single payer.
They tried the back door of the phony public option, and it didn't work because people figured out what the public option is. People are not that stupid, especially when you tell 'em, "OK, you got private insurance agencies here in the private sector, and then you've got the public option," and you've got businesses who are already panicked at their health care costs who would love to offload their health care costs to the government, the public option. And the public option run by the government, it does not have to turn a profit so if you do -- if you have to make a profit in the private sector -- there's no way you can compete and stay in business with an outfit that doesn't have to make a profit. Now, co-ops. Co-ops. As long as they're going to create some government entity and as long as they're going to make private insurance unsustainable with limits and regulations and taxation, their objective is the same. Co-ops! Man, you people at the administration, if you're going to try to fool us by thinking you're dumping the public option, well then come up with some name that doesn't reek of liberalism. [Premiere Radio Networks' The Rush Limbaugh Show, 8/17/09]
Claim echoes GOP press release
GOP: " 'Public option' by any other name is still government-run health care." In an August 17 press release, the Republican National Committee asserted:
Co-Ops Would Be Funded By Federal Government. "Senator Kent Conrad, a Democrat, proposed creating nonprofit, member-operated health cooperatives to compete with insurers ... The government would offer start-up money -- Conrad said $6 billion would be needed -- in loans and grants to help doctors, hospitals, businesses and other groups form nonprofit cooperative networks to obtain and provide healthcare." ("Q&A -- Co-Ops In Focus In U.S. Health Care Debate," Reuters, 7/30/09)
Co-Ops Would Be Regulated By Federal Government. "Advisory board makes recommendations to HHS Secretary who makes final decisions about approvals of business plans ... Business plans must meet governance standards, and eligible applicants must meet the standard for non-profit, participating mutual insurance." ("Senate Finance Committee Draft Proposal," 6/19/09)
Co-Ops Would Force Individuals Who Want To Join To Go Through State Governments. "Co-op membership would be offered through state insurance exchanges where small businesses and individuals without employer-sponsored plans would shop for health coverage." ("Q&A -- Co-Ops In Focus In U.S. Health Care Debate," Reuters, 7/30/09)
Federal Government Would Use Co-Ops To Monopolize Health Insurance. "[T]hese co-ops sound a lot like a health-care Fannie Mae and Freddie Mac, which Congress created because there was supposedly no secondary mortgage market. The duo proceeded to use their government subsidy to dominate the market and drive out private competitors." (Editorial, "Fannie Med,"The Wall Street Journal, 7/30/09) [RNC press release, 8/17/09]
Progressive economists argue public option far more effective
Reich: Co-op "bamboozle" "won't have any real bargaining leverage to get lower prices." In a June 11 post to The American Prospect's blog, Tapped, former Clinton Labor Secretary http://robertreich.blogspot.com/" target="_blank">Robert Reich described the co-op proposal as a "bamboozle" and said "[n]onprofit health-care cooperatives won't have any real bargaining leverage to get lower prices because they'll be too small and too numerous. Pharma and Insurance know they can roll them. That's why the Conrad compromise is getting a good reception from across the aisle." He continued:
The truth is that there's only one "public option" that will truly bring down costs and premiums -- one that's national in scale and combines its bargaining power with Medicare, and is allowed to negotiate lower drug prices and lower doctor and hospital fees. And that's precisely what Pharma and Insurance detest, for exactly the same reason.
Whatever it's called -- public option or chopped liver -- it has to be able to squeeze Pharma, Insurance, and the rest of the medical-industrial complex. And the more likely it is to squeeze them, the more they'll fight it. And the greater the opposition from Republicans, and from Dems who either believe any bill has to have some Republican support or who have sold themselves out to the medical biggies.
As long as single-payer is off the table, then we need a real public option. Don't be fooled by labels. Demand the real thing. [Tapped blog post, 6/11/09]
Hacker: Co-ops "not going to have the ability to be a cost-control backstop, much less a benchmark for private plans." In a June 14 post to The New Republic's blog, The Treatment, University of California-Berkeley professor http://www.polisci.berkeley.edu/Faculty/bio/permanent/Hacker,J/" target="_blank">Jacob Hacker argued that Sen. Kent Conrad (D-ND) "has offered no reason to think that the cooperatives he envisions could do any of the crucial things that a competing public plan must do." Hacker continued:
An easy way to think of the public plan's functions is the three "B"s: We need a national public plan that is available on similar terms in all parts of the nation as a backup. This plan has to have the ability to improve the quality and efficiency of care to act as a benchmark for private insurance. And it has to be able to challenge provider consolidation that has driven up prices to serve as a cost-control backstop.
Cooperatives might be able to provide some backup in some parts of the nation, but they are not going to have the ability to be a cost-control backstop, much less a benchmark for private plans, because they are not going to have the reach or authority to implement innovative delivery and payment reforms. And so Conrad's idea appears to be yet another compromised compromise that cuts the heart out the idea of public plan choice on the alter of political expediency. [The Treatment blog post, 6/14/09]
Not only is Obama clearly ready to throw the public option overboard, he is embracing the requirement that we all be forced to buy insurance from private insurers. That means your tax dollars and mine will be used to pay subsidies to the big insurers to provide coverage to people who can't afford to buy their policies, because the big insurers charge far more than they should because Wall Street investors demand that they do.
One of the people who undoubtedly talked Obama away from the public option and into supporting this mandate is his new BFF, Aetna CEO Ron Williams. Williams, who made $65 million off of Aetna's policyholders' premiums over the past two years and who was the mastermind behind Aetna's shedding of eight million members a few years ago to meet Wall Street's demands, is the insurance industry's leading champion of requiring us all to buy insurance. And, of course, without a public option, we'll all be forced to buy coverage from Aetna or one of the other private insurers.
According to a recent article in Forbes, Williams has been to the White House a half a dozen times recently to advise the president and his staff on health care reform. That same article quoted a Wall Street analyst as saying that Aetna likely will dump about 600,000 policyholders during the coming months to satisfy its investors' unrelenting profit demands.
During his speech in Montana, Obama talked a lot of trash about the insurance industry. Don't be fooled by that tough talk. It's all part of a strategy to try get us to believe we'll get the reform he promised during the campaign. Industry leaders are in fact delighted he's denouncing their behavior, because they believe most of his supporters -- who were hopeful the stars might finally have aligned for real reform -- will be fooled into thinking the reform bill that reaches his desk will benefit them more than the special interests with their armies of lobbyists. And they know the nonprofit cooperatives Sebelius and Gibbs are now trying to sell us on don't have a prayer of succeeding. The big for-profits will never let them get off the ground in any meaningful way.
Sadly, I believe the fat cats are winning and that the bill Congress sends the president will be one that gives an industry with an unsustainable business model a new lease on life and a guarantee of unprecedented future profits.
So I hope the president's aides are buying lots of lipstick. He'll need all he can get to put on that pig of a bill.
On the August 18 edition of Fox News' America's Newsroom, after co-host Bill Hemmer noted the results of an Ipsos/McClatchy poll question -- which he incorrectly said was an ABC News poll question -- asking if the public option would provide better care than private plans, Fox News vice president for news and Washington managing editor Bill Sammon claimed that "people are saying they don't want the public option, as that poll demonstrates." However, when the Ipsos/McClatchy poll specifically asked respondents if they believed "it is necessary to create a public health insurance plan," 52 percent of respondents agreed. Numerous other recent polls also show that a majority of Americans support a public option.
I've argued before that reconciliation will not work for comprehensive health-care reform. Today, Kevin Drum comes to the same conclusion. Stan Collender, a budget expert, backs him up. I go into the reasons in more detail here, but the Health Insurance Exchanges would probably be thrown out. The insurance market reforms would probably be thrown out. Prevention and wellness, modernization, delivery system reforms, and much else would likely be out the window. And we can't even quite predict what would be lost, so it's hard to know what would actually work at the end of the day. We could end up with a bill that simply doesn't work, much as a car doesn't function without a transmission system.
But the 2004 Dean proposal, which I've been talking about lately, offers a good example of the sort of bill you could pass. Dean basically folds the Children's Health Insurance Program and Medicaid into one program called the Families and Children Health Insurance Program and makes everyone up to 185 percent of the poverty line eligible for it. He also allows people between the ages of 55 and 65 to buy into Medicare. He creates a tax credit for people in the middle.
Those changes alone would be a lot less than what we're looking at in health-care reform. They would cover, and help, many millions fewer than the House bill. But they would nevertheless help a lot of people. And they are directly related to federal programs and directly reliant on federal expenditures. Fund them through Medicare and Medicaid changes, alongside a small surtax on the wealthy, and it's tough to see anything that would give the Senate parliamentarian cause to object.
That's not a great outcome, but that's probably the best you can get in reconciliation, and it would be a step forward. And as a conceptual matter, that's probably the best way to think about reconciliation: as a place where you can aggressively expand public programs, rather than a place where you can reform the American health-care system. Depending on how you look at it, it's second, or third, or fifth-best. But it's better than nothing.
I doubt this was part of some master plan, but Noam Scheiber has a smart take on the long-term fallout of yesterday's "liberal revolt" over the public plan:
Prior to all the apoplexy on the left, the two poles of the debate were the president, who wanted a reasonable, fairly moderate set of health insurance reforms, but was nonetheless being branded a socialist or whatever, and a lot of lunatics on the right screaming about death panels and enemies lists and home invasions.
Around the conference table at TNR, we've been saying for weeks that what Obama really needed was a group of equally vocal, equally zealous critics on the left, pulling the debate's center of gravity in the other direction. And, wouldn't you know, that's exactly what's happened over the last 48 hours. We've now got a pole on the left to match the intensity of the pole on the right. (Don't get me wrong: I'm not suggesting a moral equivalence between the two. As far as I'm concerned, the critics on the left are basically right and the critics on the right are either insane or deeply cynical.) From a sheer tactical perspective, I think the White House and the Democratic leadership in Congress have dramatically improved their position.
The benefits arise both in the broader national debate and in the congressional negotiations. In the national debate, Obama now looks like the centrist voice of reason instead of an over-ambitious lefty (I'm caricaturing, of course, in the spirit of the cable-news coverage). Inside Congress, Obama may not get a public option, but if he doesn't, he was never going to get it. And now he can extract a ton of concessions in return, because he can point to a left-wing of his party that's ready to eat him alive for failing to deliver on it (whereas that left-wing outrage was largely hypothetical before now). That kind of leverage is extremely helpful.
Fox News contributor Dick Morris has repeatedly claimed that Democratic plans for health care reform will cover "illegal immigrants" while denying medical care to American citizens, particularly the elderly. However, both the House tri-committee bill and the Senate HELP committee bill explicitly prohibit undocumented immigrants from receiving federal payments to purchase insurance.
Actually, I really don’t even want to think about health care right now. It’s too painful. Have the Obama team learned nothing from the past 16 years? No concession will satisfy Republicans — they’ve said so themselves! Yet the administration keeps signaling weakness.
After reporting on August 17 that "there are signs that the administration may be backing off the so-called public option," ABC's World News host Charles Gibson went on to cite "experts" who said, in Gibson's words, "[I]f you take out the public option in terms of insurance, there's going to be no restraints on the cost of insurance." But in the three months prior, World News has never cited any health experts making that point; rather, correspondents only reported that the intention of the public plan was to drive down costs or cited Democrats making that claim.
The public option as a signal
Look, it is possible to have universal care without a public option; Switzerland does. But there are some good reasons for the prominence of the public option in our debate.
One is substantive: to have a workable system without the public option, you need to have effective regulation of the insurers. Given the realities of our money-dominated politics, you really have to worry whether that can be done — which is a reason to have a more or less automatic mechanism for disciplining the industry.
The second is what the option debate says about Obama.
If progressives had real trust in Obama’s commitment to doing the right thing, the administration would have broad leeway to do deals. But the president doesn’t command that kind of trust.
Partly it’s a matter of style — as many people have noted, he has been weirdly reluctant to make the moral case for universal care, weirdly unable to show passion on the issue, weirdly diffident even about the blatant lies from the right. Partly it’s a spillover from his other policies: by appointing an economic team that’s Rubin redux, by taking such a kindly attitude to the banks, he has squandered a lot of progressive enthusiasm.
Add in the dealmaking as part of the health care process itself, and progressives can be forgiven for having the impression that Obama (a) takes them for granted (b) is way too easily rolled by the other side.
So progressives have their backs up over one provision in health care reform that’s easy to monitor. The public option has become not so much a symbol as a signal, a test of whether Obama is really the progressive activists thought they were backing.
And the bizarre thing is that the administration doesn’t seem to get that.
In an August 18 Associated Press article, David Espo quoted Sen. Mitch McConnell's claim that health reform proposals will be paid for "through massive cuts to Medicare," without pointing out, as FactCheck.org did, that "[t]he claim that Obama and Congress are cutting seniors' Medicare benefits to pay for the health care overhaul is outright false." Additionally, Espo quoted McConnell's assertion that health reform will be funded through "taxes on small business," without noting that according to House Democrats, the nonpartisan Joint Committee on Taxation concluded that only 4.1 percent of small businesses would be affected by the surtax in the House Democrats' health reform bill or that the Senate HELP bill provides credits to help small businesses comply with the mandated coverage provisions.
The Post Uncovers the Truth: President Obama's Health Care Plan Won't Make Time Stand Still
Nothing can escape the Post's team of super-sleuth investigative reporters. President Obama has been going around the country telling people that he wants to create a public health insurance plan that they will have the option to buy into. And then he tells them that if they like their current plan, they can keep it.
To most people, this statement presumably means that under President Obama's proposal, people will not be forced to buy into the public plan. Of course this statement is true. The plan as proposed by President Obama would not force anyone to buy into the public plan.
However, the Post's super-sleuth reporters took matters a step further. As it reports in a major page 2 article today, the President's plan can change the dynamics of the insurance market. Some employers who currently offer coverage may decide not to, if they know their workers have the option to buy into a public plan. Or, they could change the plan they have. In either case, it would mean that people would not have the option to stay with the plan they have today.
Of course, under the current system there is no guarantee that workers have the option to keep their current plan. Employers are dropping coverage all the time. Others switch plans; there is a whole industry of insurance brokers who support themselves by getting companies to switch plans. In addition, the insurers themselves can change their plans, so that good plans may become less attractive through time. In all of these cases, even under the current system people cannot be guaranteed the option to stay with their current plan.
In short, President Obama made an absolutely true and meaningful statement in claiming that people would be able to keep their current plan, if they like it. His proposal would not force them to buy the public plan. However, if anyone thought that President Obama was pledging to freeze time and ensure that their health care plan would always stay the same, then the Post has performed a valuable service in correcting this misleading impression.
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