"MD's Sob Story"

I’m not Raul Grijalva or Jerry Nadler, but I thought I’d try to respond to TPM reader MD’s “sob story” (as MD called it) because the story illustrates the issues at stake in health care reform. Here’s the story.

Like everyone I have a sob-story to tell about health care. After telling it to countless liberals who oppose the Senate’s health-care reform bill, I still haven’t heard a good answer from them about why they can’t support the Senate bill. They usually stop talking, or try to change the subject.Maybe Raul Grijalva or Barney Frank or Anthony Weiner or Jerry Nadler have wrestled with this problem and I haven’t seen it. Have you seen anything from them about this?

My story: My father is dying of Huntington’s disease. Before he dies in 8 to 10 years, he will need anti-depressants, anti-psychotics and drugs that fight dementia and his tremors and convulsions. He’ll need multiple brain scans and physical therapy sessions.

Current medical treatments can’t save him, but they will give him a few more years before the slow death strips him of his memories, personality and control of his body.

There’s a 50 percent chance the same slow motion death awaits me and each of my three siblings. If I ever lose my job I’ll become uninsurable, permanently. My sister already lost her insurance.

That means whatever treatment is developed for Huntington’s will be unavailable to us. There’s simply no way we could afford it. Not only high tech gene therapies or other interventions, but the medications and treatments that exist now that would buy us enough time to see our kids’ graduations or weddings, and would give them hope of not suffering their grandfather’s fate.

There’s a bill that would mean we’d never be rejected for health insurance or have it canceled. Health insurance that could ease our final years, or maybe even save us.

But liberals are refusing to support it. I know there are principles and politics at stake. I know people are tired of being told to shut up and take what’s given to them. But in the end, there a thousands of people with Huntington’s and millions of people with other serious or terminal illnesses who will never benefit from treatment because they are uninsured. Millions more who are otherwise healthy will die premature or unnecessary deaths because basic health care isn’t affordable.

What do liberal leaders say to them? What do those liberals tell people like my dad, a die-hard activist Democrat, a UAW member who worked his way through college to become a teacher?

I’m used to Republicans and conservatives not giving a damn about people like us, or mocking us for asking questions like this. That’s why my father spent so much of his life fighting to keep Democrats in power. But to be abandoned by people my father worked with and supported his entire life? What in the bill is so terrible to justify that?

This isn’t about betrayal, or a slap in the face, or an insult. It isn’t about strategies to keep seats, or grand theories of justice. Democrats in Congress have the chance to cast a single vote that will make the lives of tens of millions of Americans less wrenching, our demises less brutal. That’s what this is about.

I’d like to hear Reps. Grijalva, Frank, Weiner or Nadler tell us why they can’t cast that vote.

Now, to begin with, MD’s entire premise is wrong. To suggest that Grijalva and Nadler are the people preventing a bill from moving forward ignores the fact that, as things stand, even with their votes, the House would be at least one vote short of passage. As I pointed out here, until MD can convince one of the following to vote for a bill, there is zero chance of the Senate bill passing: Bart Stupak, Larry Kissell, Dennis Kucinich, Eric Massa, or any number of Blue Dogs who refused to vote for the bill the first time. MD would do better yelling at the Catholic Bishops, who think it’s more important for Bart Stupak to make choice less accessible to all women than it is to provide lots of poor Catholics health insurance, than he would yelling at Grijalva and Nadler.

And because the bill is at least one vote short, it is going to have to get more populist (to convince Kucinich or Massa to support it) or still more conservative (to get either the anti-choice vote or the Blue Dog vote) before it passes, presumably through reconciliation.

And frankly, it may get better in ways that are very important for MD and his family. MD doesn’t explain his situation well enough to be clear, but I will assume his father currently has health insurance through either the UAW or a teacher’s union and has not yet reached Medicare age (because otherwise, the debate is primarily about whether MD’s father has to pay for drugs in the Medicare Part D donut hole).

One of the reasons why Grijalva and Nadler do not support the Senate bill, as is, is because it would lead people like MD’s father to pay more out-of-pocket for his care–because that is the entire point of the Excise Tax. Starting in 2013, MD’s father might have to pay higher deductibles each year, he might have to pay for his physical therapy, he might find some of the expensive medicines unavailable to him. As an example, after my health care went through the kind of changes envisioned under the excise tax, I had to start paying $800 for necessary MRIs once or twice a year. And under my new plan, I would have had to pay $560 six times over the course of cancer treatment (a total of $3,360) for one of the really expensive drugs I took, a drug just like the expensive drug therapies MD refers to.

So MD needs to understand that Grijalva and Nadler want the changes that must happen before this bill passes to benefit MD’s father, to prevent him from losing his current level of care, rather than benefiting a bunch of millionaires.

And, presuming those changes would push in the direction of House bill on other issues, there is a benefit for MD and his sister–who have what is counted as a pre-existing condition–as well. I’m very sympathetic to their plight, because as of October, when I’m scheduled to lose my COBRA, I will be, like his sister (and like he’d be if he lost his job) uninsurable.

For starters, the House bill allows people to keep COBRA until the exchanges go into effect (2013 in the House bill, 2014 in the Senate bill). Grijalva and Nadler are fighting to make sure that if MD lost his job, he could keep his current insurance until such time as he could get health care through the exchange. For me, this would be a huge benefit, because as expensive as COBRA is, it’s far cheaper than I would have to pay for any health care I could get, if I am able to.

As for MD’s sister, Grijalva and Nadler are fighting so that MD’s sister can access high risk insurance right away; under the current Senate bill, MD’s sister must go for six months without insurance before she can tap into the federal high risk pool. And the high risk pool for his sister would be half as expensive if Grijalva and Nadler get their way. Plus, under the Senate bill, there is a dollar limit on how long the federal government can offer that high risk insurance; the CMS has estimated that the money would run out “by 2011 and 2012,” so MD’s sister might well lose health insurance or pay even more between now and when the exchanges, under the Senate bill, open in 2014. And note, if Grijalva and Nadler get their way, MD’s sister can enroll her whole family in the high risk pool, whereas under the existing Senate bill, only she would be able to enroll.

Finally, one more thing. If Grijalva and Nadler have their way, then MD’s father’s drugs will be cheaper, both because they’re fighting to lower the exclusivity periods for the high tech gene therapy MD refers to from what is currently in the Senate bill. And because they’re fighting to prevent pharmaceutical companies from making deals with generic manufacturers to hold off on production of generics so as to postpone competition for a number of years. Again, for people facing years of medical care, such things will make a huge difference in quality of life.

So before MD starts beating up progressives, he ought first beat up the Catholic Bishops who are standing in the way of a bill. And because the House is at least one vote short of passage–even with the progressives who voted for it the last time–there will probably be an agreement to change the bill in reconciliation. And one of the first things that will happen–one of the things Grijalva and Nadler are fighting for–is to make sure that middle class union members like MD’s father don’t have their health care cut dramatically just to shield a bunch of millionaires from higher taxes.

So, I agree with MD–this isn’t about strategies to keep seats. It’s about making sure MD’s father gets to keep the health care he already has.

Update: Corrected per lizard’s comment.

Update: CMS link included, language updated. Generics language updated.

  1. klynn says:

    Simply beautiful.

    I hope there is a link to this over at TPM.

    Thank you for addressing the indirect and direct “monster” name calling with a clear and professional layout of the issues that Grijalva and Nadler are fighting for through the House bill. Otherwise known as “care and compassion based health reform.”

    Hope this gets front paged ASAP.

  2. Phoenix Woman says:

    Thanks for this, Marcy.

    I find it amazing that TPM and other defenders of the current Senate bill are spending so much time attacking Nadler and Grijalva for wanting to fix the Senate bill when Stupak and the Blue Dogs would be happy to kill it outright.

  3. earlofhuntingdon says:

    As you say, and as we’ve debated at length on your blog,

    One of the reasons why Grijalva and Nadler [and many others, including, you know, voters] do not support the Senate bill, as is, is because it would lead people like MD’s father to pay more out-of-pocket for his care–because that is the entire point of the Excise Tax.

    The purpose of the excise tax – apart from a blunt instrument to raise money – is precisely to make health insurance more expensive so that the many use it less, which means they get less health care. Executives and legislators who have similar, full-coverage insurance plans won’t feel that pain, because compensation committees or taxpayers will pick up their extra costs. Not so if you used to work in Saginaw or Syracuse or the Central Valley. That’s not health care reform. That’s budget balancing on the backs of the people you claim to want to help. That’s today’s Democratic leadersheep.

    • MsAnnaNOLA says:

      This is why I am so outraged by this bill. It makes insurance more expensive by raising the cost to individuals. This sets up a false choice. AS IF people have a choice to spend money or not on their healthcare? If your kid is sick and a doctor tells you you have to do X…do you have a choice of doing X or not doing X? Not really.

      This is a probelm that I always had with the Bush mantra that we will force people to use their own money in high deductible plans, they will shop around and they will use healthcare less. The democrats are now going down this road as well. Problem is as Marcy has pointed out so eloquently so many times, people can’t afford the premiums to begin with let alone have money left over to go to the doctor when they need to. So many many people will gamble that they won’t get really sick, save the premium cost and pay out of pocket to the doctor when the kid has the sniffles. Problem is chances are someone in the family will have a serious condition sooner or later and either won’t get care at all or will end up in the emergency room. This is no solution, but this is what I believe the senate bill will be forcing people to do by not limiting the cost of premiums.

      Of course in Louisiana we had a statewide public hospital system. This system is now in jeopardy because of cuts in Medicare reimbursement et all. The hospitals were available to all, the indigent and unable to pay would pay less or not at all. The main hospital in New Orleans where we trained LSU and Tulane doctors was one such hospital. Of course our right wing Gov Jindal wants to kill this whole system, even though that means denying mental health care to disturbed children in the wake of the Katrina nightmare.

      Seriously with all the money we are talking on spending on this health insurance give away I wonder how that cost would compare to just setting up federal hospitals and clinics and doing what Louisiana did before. Make world class care available and model them on the Mayo Clinic. If you have insurance you pay if you don’t then you don’t or on some sliding scale. Seems to me this way the people actually get the care instead of lining the insurance companies profit margin which is not necessary in order to provide care.

      • earlofhuntingdon says:

        It’s not how much money the federal government spends, but in whose pockets it goes. Insurance companies, defense contractors, mercenaries, banks and foreign tribal leaders are OK. Average American citizens, not so much. That’s one reason the Citizens United case will have such an impact: it increases the momentum of a train already going too fast and headed off the rails.

    • Synoia says:

      “The purpose of the excise tax – apart from a blunt instrument to raise money – is precisely to make health insurance more expensive so that the many use it less”

      This may be a cost benefit, maybe not the major benefit of the tax. My take is the major reason for the excise tax is to force employees into cheaper plans, and cut their employer’s costs.

      That’s “bending the cost curve.” The employer’s cost curve.

      • emptywheel says:

        Problem is there is zero evidence that employers will “save” money–rather than keeping HC costs constant over the years. Krugman has suggested that the claim that they would save money is wrong. And if cutting from Gold to Silver plans would have “bent the cost curve,” it would have already done so, because employers have been making precisely the moves incented by the Excise Tax for the last thirty years. But we’ve seen none of the things that excise tax boosters promise.

        I would suggest lived experience, in this case, is a better read on what will happen than an abstract theory by an economist in an ivory tower.

        • allan says:

          Please excuse my linking to Nice Polite Republicans, but yesterday NPR had a piece where
          they sat down a working class woman from southwest Virginia with a chaired economics prof from UVa.
          The idea was for him to explain to her how the excise tax would raise her salary. Not too convincing.

          • emptywheel says:

            No, and they chose not to get Larry Mishel as the economists; he would have agreed with the union worker that she was likely right that she would get no raise out of this. And they chose not to mention that Gruber has admitted he oversold the claim and that Krugman has said people like Gruber were exaggerating.

        • Leen says:

          In the many nursing homes that I have spent time in the last several years. Hear over and over again that the GM retirees are satisfied with their health care coverage packages (I believe the Obama administration would consider these part of the “cadillac” plans) This is a consistent response.

          Our seniors without this kind of coverage have major complaints and are often endlessly run around by private insurers or cut off of therapy they need. Hello Micheal Moore tens of thousands of these stories in our nursing homes nation wide.

  4. earlofhuntingdon says:

    [U]nder the current Senate bill, MD’s sister must go for six months without insurance before she can tap into the federal high risk pool.

    That waiting period is for the convenience of the government, both to lower its out-of-pocket costs (which means you get less insurance or care and a lot more worry and heartache) and to lower its administrative burden. It uses an old assumption about how quickly unemployed people get back to work and an even older assumption about that work including the benefit of health insurance. Both assumptions are highly suspect in today’s economy, more so in this jobless recovery.

    The Senate is making its job easier because an awful lot of senators don’t think the people deserve better access to health care and at least as many would rather lose their jobs than allow Barack Obama a credible legislative or substantive victory that would enhance his or his party’s electoral prospects. The Senate bill and those senators aren’t doing much, MD, to help you or your family or the millions like you.

    • masaccio says:

      A huge part of the cost of catastrophic illness is in the first six months, so this will save a boatload of money which the uninsured and underinsured sick will pay just to survive to the date when they can get the benefit.

        • lynnm says:

          I am a Huntington’s Disease (HD) advocate and I want to comment on the skepticism about MD’s story. It is very hard to get Social Security Disability for this disease in a timely fashion. About a quarter of the people who are at risk for the disease don’t even know it because of misdiagnoses, family secrecy, or they are a new mutation (about 8-10 percent of cases are). In addition, most people with HD don’t recognize the onset of their symptoms. And worse, onset of the disease has been defined by a substantial amount of movement disorder. New research shows that cognitive and psychiatric impairment starts as much as two decades before the characteristic involuntary movements. The result of this is that many people have lost jobs and benefits before they are diagnosed as disabled. Even then, Social Security usually turns people down at least once for this because the Blue Book criteria don’t fit the disease. There is a two year, five months delay after getting SSD before Medicare kicks in. And what about the spouse and children who were dependent on the patient’s former corporate job for their own insurance?

          It is not true that the heavy expenses are all at the back end of the disease. You’ve got a younger person, average age 39.5, who needs expensive medications. Responding to all the early psychiatric problems can easily result in a spouse losing a good paying job and having to take a part time job or try to work at home. If there are kids in the house, then they have to be protected, they can’t be left alone with an HD patient. People with this disease can go from a comfortable middle class lifestyle to bankruptcy in a few short years — and not because of end stage HD.

          The Robert Woods Johnson foundation conducted a study a few years ago which concluded that if you wanted to design a disease that falls through the cracks in the medical and social service systems, you could do no better than Huntington’s Disease. I could tell you sob stories until the cows come home. They would be anecdotes of course, but they are also characteristic of the lives of people affected by this disease. It is heartbreaking.

          • Praedor says:

            It is a horrible disease, and it is heartbreaking, but it is also absolutely incurable and untreatable. Palliatives are all that are available.

            Providing palliatives is not worth making women’s bodies community property or protecting insurance company profits or big pharma profits. The harm in the bill is greater than the good.

            There are other ways to get a fix for HD sufferers and selling out the entire American public to big corporations is NOT one of them.

            • lynnm says:

              I agree that we need a better bill. My point was only that MD is almost certainly real and justifiably frustrated.

              And don’t underestimate the importance of palliative care. HD patients live another 15 – 20 years after diagnosis. That’s a lot of suffering and I can tell you based on my experience in my first marriage and those of many, many friends, without medication, people with this disease are almost always unbearable to take care of and of course they are angry, depressed and miserable and don’t want to feel like that either. There are so many resources available to Alzheimer’s patients because they are elderly but few available to HD patients because they are younger. People try to access resources for the brain damaged and are sent to departments of mental health where they are told, this isn’t a mental illness, it’s organic brain disease.

  5. earlofhuntingdon says:

    This story fits into the village meme that it’s always DFH’s who need to compromise, never the stalwart conservatives who are the backbone, or some other bone, of government and society. I would have thought that eight years of George Bush and one of Barack Obama would have illustrated how misplaced that myth is.

    • Jeff Kaye says:

      Yes, it’s all about blaming those on the left, when the right and their corporatist enablers have been killing people, bilking them, and letting others die for years.

      I have plenty of “sob” stories, too. But as a medical provider, I can’t talk about them, due to confidentiality issues, which in mental health is especially important. But I can tell you that the Senate bill offers very little to the individual patients I’ve seen.

      Also, from an analysis viewpoint, it’s wrong to mix categories, i.e., to talk about personal stories and social policy for everyone, when discussing the bill. There’s always going to be someone who is “left out”, or doesn’t benefit. One can speak of both issues, but to conflate them, and then criticize one political group, accusing them, essentially, of killing someone’s father, or letting him die… well, that’s not just unfair, it’s outrageous. I can’t believe TPM would publish this “as is”.

      When considering the stakes of a major social reform such as health care reform, one must balance many different factors. What human cost can we put on the fact that an immense transfer of wealth is being proposed via the mandate sans PO to very rich, and very unethical insurance companies (and and the corporations that own them)? One life. Ten. A thousand.

      It’s silly to even talk of it that way. Consider, on the other hand, how calloused this country has become towards the deaths of others, i.e., the chronic number of 30 souls who perish everytime there is a terror Predator attack on a group of innocents in Afghanistan. But, but… what about freedom?

      Thank you Marcy for putting some common sense into the discussion. I hope they post your essay at TPM.

      • solerso says:

        and the worst part is, as true as the stories may be, the reason they are pulling our all the stops is to extort money, not because its good policy. these kinds of stories (used like this) are kind of like chechen kidnapping-snuff videos. they are emotional terrorism and there is no good reason to publish them.

  6. der1 says:

    As if the Catholic Bishops give a shit about providing compassionate care:

    May 21, 2001 – Last week, CHW and its six-hospital regional system, Mercy Healthcare Sacramento (Calif.), paid almost $10.3 million to settle a federal whistleblower lawsuit that charged two physician clinics with submitting false claims to federal health insurance programs and California’s Medicaid program.

    The settlement comes just more than a week after CHW was served with another whistleblower lawsuit that involves the filing of false Medicare claims at its 291-bed St. Joseph’s Medical Center, Stockton, Calif.

    Catholic Healthcare West (CHW) is a California not-for-profit public benefit corporation that operates hospitals in California, Arizona, and Nevada[1]. As such, it is exempt from federal and state income taxes. CHW is the eighth largest hospital system in the nation and the largest not-for-profit hospital provider in California.

    Did they change their ways?

    Catholic Healthcare West settles lawsuit:

    June 14, 2006 – A large non-profit hospital chain has settled a class action lawsuit filed over the prices it charges uninsured patients. Catholic Healthcare West, which operates 40 hospitals in California, Arizona and Nevada, has agreed to pay an undisclosed sum believed to total “hundreds of millions” of dollars. The suit accused CHW of charging uninsured patients up to five as times as much as those with insurance or access to Medicare or Medicaid.

    Read more: http://www.fiercehealthcare.com/story/catholic-healthcare-west-settles-lawsuit/2006-06-15#ixzz0dSdgcj3N

    2 cases of fraud in 5 years think that had an effect?

    January 15, 2010 – Patients learn they might have unneeded stents
    Federal probe focusing on procedures; 369 St. Joseph heart patients affected

    St. Joseph Medical Center in Towson, whose cardiology business is a focus of a continuing federal health-care fraud investigation, has notified hundreds of its heart patients that they may have received expensive and potentially dangerous coronary implants they didn’t need.

    “We take our interaction and the care of our patients with the utmost seriousness, and so we wanted to alert patients and their physicians to what we found,” said Norman (CEO Jeffrey K. Norman).

    Thank the bishop’s god for “Serious” CEO stewards. And if you can’t get it from the rubes through the collection plate steal from, I mean overcharge, the protestant/atheist/jewish/muslim/wiccan taxpayer (my apologies for leaving others out).

    • Leen says:

      “As if the Catholic Bishops give a shit about providing compassionate care”

      Some do for sure.

      When my nursing home bound father and I watch some of the Catholic (he is a hard core Catholic/Dem/labor union kind of guy) goings on in the upper echelon of Rome etc on the news. I have a standard line when the Pope, Arch Bishops, Cardinals, Bishops come out in all of their silk, linen, lace and Italian made slippers and leather shoes “give that money that you spent on that fancy garb back to the poor” I also say “Jesus would roll over in his tomb if he saw these guys in that fancy garb” These lines always make him laugh hysterically so I repeat them for all of his retired and nursing home bound pals too. They all have a good laugh.

      “give that money spent on those clothes to the poor”

  7. Mauimom says:

    Thank you, Marcy.

    I was both furious and depressed when I saw this “sob story” @ TPM: furious at Josh for posting it without any analysis or response; depressed that a poor voter thought this shit health care bill would cure his problems.

    Has Josh allowed you to post your reply to this travesty, or is he keeping the door shut against sunlight?

  8. allan says:

    TPM’s race to the bottom (of the veal pen) has been fast, depressing and scary.
    If they can get to Josh Marshall, they can get to almost anybody.

    • Riesz Fischer says:

      I don’t see it that way. I’ve always considered Josh a centrist. But I give him credit for helping save Social Security during the Bush regime, when they were trying to pull it down. But he’s always been in the veal pen.

  9. gimlet says:

    From the story, I would think the father would be eligible for disability and Medicare after a year of disabling symptoms.

    • emptywheel says:

      Agree. In which case this is all about pre-existing conditions, which aren’t going to be threatened if they do sidecar reconciliation, which is the most likely way forward.

  10. masswaster says:

    After telling it to countless liberals who oppose the Senate’s health-care reform bill, I still haven’t heard a good answer from them about why they can’t support the Senate bill. They usually stop talking, or try to change the subject.Maybe Raul Grijalva or Barney Frank or Anthony Weiner or Jerry Nadler have wrestled with this problem and I haven’t seen it. Have you seen anything from them about this?

    “Thanks for the fax, Lanny.

  11. gimlet says:

    There’s a 50 percent chance the same slow motion death awaits me and each of my three siblings. If I ever lose my job I’ll become uninsurable, permanently. My sister already lost her insurance.

    Thought insurance companies just put a rider on for Huntingtons related problems and still covered heart disease, cancer, etc.?

  12. peterboy says:

    Emptywheel, as usual, is all over this thing and doing it well.
    I applaud several of the pluses in the House bill and also point out that the Senate was very soft on the medical loss ration.

    A good law would require insurance companies to spend 90 percent of premium on medical care, include a pre-existing condition ban for everyone not just kids starting in 2010, make the rating standard the House 2x rating for older insured and would also include a permanent COBRA extension for workers who lose their jobs.

    Like Emptywheel lots of folks–prolly many millions with all the unemployed– would greatly benefit from being able to stay on COBRA, even at cost because CORBA is far cheaper than the high-risk pool.

    The COBRA extension for the unemployed is in the House bill, Section 113. 
We need to help the unemployed keep their insurance until the exchanges start, without forcing them into expensive high-risk pools.
    Section 113 of the House bill permits the unemployed, many of whom can’t get individual coverage because of pre-existing conditions, to buy into their old group insurance until the insurance exchanges start in 2013.

  13. dakine01 says:

    Yeah, with all due respect to MD and family, to blame “liberals” for all these problems and delays is a total msi-read of the facts on the ground and a total buy-in to the insurance company spin.

    (And as an FYI for those who may not be aware, Huntington’s Disease aka Huntington’s Chorea) is the disease that killed Woody Guthrie.)

  14. solerso says:

    get rid of the mandates, get rid of the anti trust exemption and force insurance to conduct their business ethicaly, do we have to extort money from people who don’t have it, to pay trillion dollar bribes to insurance companies, to make them behave like humans? everyone has a sob story. i will die without health care. i’m not willing to die without health care AND pay what little i have to insurance industry thieves for nothing. this bill presents a horrific class problem. its another way to divide us along class lines. it needs to die

  15. drucarr says:

    I’ve been one of the “sellouts”, as some on these posts like to call them, that have tended to say “just pass the f’in Senate version” and then we’ll live another day to fight it out on public option, expanded Medicare, etc. I’m not entirely still off of that yet, but I do think improving the bill, now, makes a whole lot of sense. Since Jane has already (correctly) emphasized that the “60” myth was always just that, this makes sense to me.

    BUT…. This all hangs on the question of whether, after Mass., the votes are there to improve the bill from the chicken-shit moderates. If there isn’t, I have to say, I’m going to be a sellout, and say “pass the Senate version”. But I AM willing to write the letters, make the call, and strongly call for improving the current Senate bill, then telling the SENATE to “pass the f’in bill”. At this point, the “rush” is over for me. Tell the House to take a deep breath, and really try to do the right thing.

    • emptywheel says:

      My read is that the House and Senate are resolving to having to use sidecar–there simply are not the votes in the House for the bill as is (as much bc we’ve lost Blue Dogs and Stupak’s 10 or so). So the question is how much the House manages to wring out of the Senate. There were 51 votes for a much more progressive option, and they could make this bill a WHOLE lot more popular if they offered Medicare buy in to 55+ (which had 56 votes or so before President Lieberman nixed it). And that would make it a lot more popular AND a much better bill.

      • drucarr says:

        Yeah, I could go for this scenario. And then big question is: will Obama lean on those House members who are hovering under their desks right now? Seems like he will have to play a role in this, finally. And I’m not sure he’ll be willing to do that, but maybe Mass. MAY have stoked fire under him? Or am I dreaming?

        This is probably a real back-ass read on the whole Supreme Court decision on the corporate-takeover of our election system, but maybe there is a silver lining to it. Maybe something like this is a rallying point that can get Obama, and even the Senate, to wake the hell up and get some real progressive blood in them.

        Or again, I am probably dreaming…

    • dakine01 says:

      … then we’ll live another day to fight it out on public option, expanded Medicare,…

      Just out of curiosity, can you give me a good example of ANY crappy legislation from the past 25 – 30 years that has been fixed after it passed? I know there has been a lot of crappy legislation (such as the credit card and bankruptcy “reforms”) that Congress knows is screwed up, yet somehow, the fixes can never seem to get done.

      • Phoenix Woman says:

        How dare you suggest that a mere girl might know what she’s talking about! Besides, if Josh links back to Marcy, then his readers would see that he’s attacking his own straw-woman creation and not the actual Marcy Wheeler.

  16. gimlet says:

    See my comments at 16, 19 and 22.

    Any MD would know this.

    Sounds like a sappy pseudostory like the ones that travel in the rightwing e-mail network. I would challenge the source to reveal more about the author.

    • drucarr says:

      You mean you really don’t think there are stories out there like this? Sure, anyone could make up this story, but please don’t marginalize it by pretending that situations like these can’t and don’t exist.

      • gimlet says:

        Not that fit the facts for this one.

        They can find one that makes some of their points, but this particular attempt is irritating at the least.

        • drucarr says:

          No, I can’t, which is why I’m re-thinking my position in the first place.

          I do know that Medicare has been significantly improved over the last 40 years, but I also know this is not comparable to that, because improving this current bill would be much more than just “expanding” on something. So you’ve got me on that point, for sure.

      • vegasboomer says:

        My first born daughter died 11 years ago after a horrific 26 month losing battle with metastatic liver cancer. She was medically bankrupt from day one of that ordeal. Notwithstanding, the medical community in southern California accorded her a relentless Four-Plus heroic effort all the way.

        There are lots of random heart-tugging sob stories cutting myriad ways. Whether they sum up to comprise empirical evidence driving policy this way or that is entirely another matter.

        • PJEvans says:

          Real initials, sappy letter. Also they never claimed to be a doctor, or even in the medical field. (My father’s initials were PIE; would that make him a menu item in your opinion?)

          (Hell, I have a friend with a cousin who’s known as Dr Pepper – really is named Pepper, and has a doctor’s degree.)

          • gimlet says:

            There’s a 50 percent chance the same slow motion death awaits me and each of my three siblings. If I ever lose my job I’ll become uninsurable, permanently. My sister already lost her insurance.

            Also never claims sister’s insurance was lost because of a family history of Huntingtons.

            • PJEvans says:

              And given how insurance companies go out of their way to find things they can use to deny coverage – for pete’s sake, ten-years-back successfully treated conditions shouldn’t even be used for that purpose – I wouldn’t believe any reason an insurer cited for denying or rescinding coverage.

  17. TheObnox says:

    I certainly won’t criticize MD for wanting the Senate bill passed, but he’s assuming that he’ll be able to afford health care if it does. Analysis here at FDL and elsewhere has shown that, if the bill goes through, many people will end up with paper-thin “coverage” that they can’t afford to use. I empathize with his plight, but he and his family are not the only ones suffering, and even if the Senate bill goes through, lots of other people will still be choosing between food and healthcare. A solution for his family is not a solution for everyone. And the mandate is a particularly egregious and pernicious piece of legislation that has no place in a democracy unless it’s coupled with a public option.

  18. McMia says:

    I find it especially galling that MD invokes the UAW and the teachers in his sob story.

    This administration and the Democratic leadership in the Senate have done nothing but spit in the face of labor. First with the EFCA and now with health care. If the Senate bill passes intact I would be surprised if any union members remained registered Democrats. I know I won’t.

    Fix it or kill it.

  19. fuckno says:

    We can help MD’s father by breaking up the bill into self standing pieces of legislation like preexisting conditions, and perhaps to help with this part: “he will need anti-depressants, anti-psychotics and drugs that fight dementia and his tremors and convulsions.”, a bill should be offered up to remedy the cost of drugs; cumulative average price of identical drugs sold in the World market would be the going rate in the US, or some such. We can attach riders to major defense bills if necessary.

    A giveaway to Big Insurance is not needed to fix some of the most egregious shortcomings of the American model of health care.

  20. liberalarts says:

    I have insurance and can’t use it for any serious medical treatment because the co-pays are too much for me. That’s the point people miss: health insurance is not health care. Health care will still be unattainable, or only minimally or short-term attainable, for the expenses passed on as co-pays. When you’re faced with serious health issues, health insurance seems like it would be a godsend, but that isn’t how health insurance actually works for major and/or long-term care.

    I went without health insurance for 25 or 30 years and at 65, thought Medicare would finally cover my med issues. Well, no, not really. A bout with cancer later, I see what the problem is. My cancer treatments were covered to a point. I’m paying the rest. And the rest which I’m paying precludes any further bills of this sort, which means I now have to avoid treatments which incur co-pays along the lines of the cancer treatment I just finished. NOW, I understand how it works. There was another post somewhere on this site from a man with excellent insurance whose wife’s cancer nonetheless cost them $12,000 out of pocket. Which he could afford, but noted that many people couldn’t. What about those people whose insurance isn’t excellent? Whose co-pays are far higher?

    Don’t, please, start on doctors fees. I have the bills from doctors and the Medicare Summary Notices. Medicare isn’t lavishing money on doctors, and I have the paperwork to prove it.

  21. orionATL says:

    Asking legislators to vote for a specific piece because it “will help me and my family” is not
    A good basis for legislative decision making.

    It is a great basis for appeals to support a certain outcome.

    There are 360 million people in the us and EVERY one of them will need some medical attention in their lifetimes.

    Some will have Huntington’, some cystic f, some will be para or quadraplegic, some will have multiple children with diabetes, retardation, autism, or psychosis.

    MD’s desperation and plea are understandable but not at all persuasable to me.

    We need to pass a bill that establishes a set of sound social structures that has the evident possibility of providing coverage for every American now and into the future.

    Of key importance is that that set of social structures tightly control inflation in medical costs without denying needed medical care to any American.

  22. gordonot says:

    Free-raised veal, first introduced in the United States on January 21, 2009, are born and raised in the pasture, have unlimited access to mother’s milk and pasture grasses, and are free to roam alongside their mothers and herd on open pastures. The meat may be a richer pink color, indicative of an all-natural diet and healthy iron consumption. Free-raised veal typically has less fat than conventionally-raised veal or chicken. Calves are slaughtered at about 24 weeks of age.

  23. Gitcheegumee says:

    Has ANYONE in the administration-or the previous ones- EVER provided evidence as to WHY the US cannot provide affordable health coverage for all its citizens-like the other civilized nations of this world have successfully done for years now?

    • fatster says:

      1) It’s Socialism. 2) We’d have to wait for weeks and months to get medical attention (this particular one finally died, but it took decades for it to go away).

      • PJEvans says:

        There were people using that one last fall. Especially people trying to claim that that’s what it’s really like, all the time, in some other country (where they don’t actually live, they just know happen to know someone who had to wait a looong time). Like that doesn’t already happen here; I know people who have run into some real problems with those so-effective HMOs.

        • gesneri says:

          I always counter stories like that with the (truthful) reply that I have long-time friends in Canada and the UK and they are absolutely appalled at our health care system here in the U.S. They all have some beefs with their system but wouldn’t trade it for ours on a bet.

  24. orionATL says:

    This business of using a particulary touching or outrageous story to evoke mass compliance with one’s political views is one of the
    Central tenets of right-wing media propaganda, aka, political advertising.

    The schema always involves a victim and a demon.

    The bush boys employing this tactic was a big part of how we were herded into a stampede of a war against Muslim nations and culture.

    Feeling Empathy Is a central part of being human, I wish I were confident that Obama had more of it than appears, but we get in trouble when empathy overwhelms judgement and analysis.

  25. orionATL says:

    Gitcheegumee @58

    No, they haven’t.

    But jon gruber’s thinking involved the assumption that 100% coverage was not feasible (he may only have talking logically here).

    Personally, I think health care for all and cost control should be this and every admin ‘s goal.

  26. Professor Foland says:

    I suggest we ask these questions of every one of the 200 Republicans in the House who voted against the House bill. THOSE are the people standing in the way.

    I wrote an annoyed note to TPM about this post. In short, the reason most people don’t have a good answer is becuase, thankfully, they’ve never had to be in the situation where they needed one. I’ve got a sob story, too, and while I ultimately decided that sidecar reconciliation was better than nothing, the decision wasn’t obvious. George Johnston’s comment at 13 is a lot of the basis why. I thought it was really unfair to suggest everyone in a similar situation would say the answer is obvious.

    The plural of anecdote is not data.

    • Gitcheegumee says:

      I sincerely hope that the light at the end of the tunnel is not a sidecar attached to a runaway gravy train.

        • PJEvans says:

          I’d say at high speed, but given that it won’t actually get here for a couple more years, that’s clearly not accurate.
          Very long, heavy train, though, with all that money it’s taking to the insurance execs.

    • PJEvans says:

      There are a couple of diaries over at the Great Orange Satan, celebrating because Plouffe is back.
      I don’t know if they remember what happened last year: he got tossed out as soon as they reached their most immediate goal. That part I’d call Rahmian maneuvering.

      • fatster says:

        Maybe Plouffe’s return signals their goal is simply “health insurance reform”–period. Once they’ve rescued the health insurance industry, gotten us some relief from the more stringent policies (that kill us or otherwise cause unnecessary suffering, including bankruptcy–but that’s another topic altogether), then they’re done. And then we get to see what they’re setting us up for next.

        • PJEvans says:

          They might want to consider that, having gotten the shaft once, some of us are less likely to believe what they’re saying this time. Even if it’s Plouffe saying it – and maybe because it’s Plouffe saying it.

    • skdadl says:

      Here I am, trying to catch up by reading backwards (I don’t know why that works, but it does), and there they are again! La famille Plouffe.

      OT, and just a PS to notes earlier today: This has been a great day to be a democrat in my country. Dozens of rallies all across the country, some very big (10,000 in TO), and then some cute li’l ones, like mine (150 — we’re small but we’re mighty), but just everywhere and very cheerful. Everyone says the same thing: people were happy to do this, joyous even, and no party politics (except mostly we want Steve gone). Where I am, it was -2 C, which is warm in this country in the dead of winter, but just no one minded. I had such a good time. Again! Again!

  27. Gitcheegumee says:

    OK, so they don’t have evidence why not.

    Anybody ever hear the Judds’ song “Why not me?”

    Well, how about a WHY NOT WE adspot with that tune as backdrop?

    • PJEvans says:

      Right up there with Shrub hiding his papers and his father’s papers until years after he dies. Must be some incendiary material in those files, too.

    • skdadl says:

      This cannot stand; I just don’t believe it will. Some scholar-journalist will pursue if the government won’t. Suspect on the face of it.

    • Leen says:

      Thank you. 70 years. Nothing to hide there. Can that number be turned over. Would think his family would want to know.

      • fatster says:

        Given what happened to him, given how desperate officials appear to want to keep these things hidden (70 years! or two generations), I’d sure be reluctant to make much of a fuss. At least not at this time. Ya know?

  28. ScrewBush says:

    Blah, blah, blah. Either on this site or on Mahablog there was a good post with a specific breakdown case — income, family size, mortgage, even down to your cable bill, etc. — and what the Senate bill would do for you if you fit the scenario. Well I matched the scenario close enough and I get nothing out of this deal. Actually that’s not true, I get taxed, perhaps fined, but still no health care. I will go MORE into a hole if this bill becomes law.

    You want to pull out a hanky, sorry no one in the family has Huntington’s, but I assure you my wife desperately, DESPERATELY, needs afforadable health care, especially mental health care. One more trip to the ER for us and I won’t be able to keep up with our mortgage.

    So my take is why didn’t liberals fight like Hell for Medicare for All. That would meet my needs, and it would have solved the health care issue for MD as well.

  29. Praedor says:

    The senate bill is a loser and is NOT the only way to correct MD’s problem. THAT particular problem can be corrected with a simple bill that says: no denying coverage for pre-existing conditions.


    It is not necessary to provide MD with insurance by sacrificing a woman’s right to control and own her own body. It is not necessary to protect insurance company profits forevermore in fix MD’s problem.

  30. kisfiu says:

    I think the point was that MD’s father did not spend his life working to elect catholic bishops. Thats why he asking those for whom he worked why they dont support the senate bill.

    Secondly, there is enough in Marcy’s post to convince me that Nadler et al have great ideas to improve the Senate bill. Wonderful. But what if they cant? That is the assumption people seem to be operating under. If this assumption turns out to be true, then all the nice ideas above do nothing to answer MD’s questions.

  31. oldtree says:

    There is no sense arguing plusses or minuses of something not worthy of consideration. The idea of compromising to give insurer’s money that is collectively what remains in our treasury is insulting. No other nation can survive without providing it’s people health care to allow for true productivity. Any thing less is fiscal disaster and ruin.
    To consider acceptance of one’s own voluntary death is not done as a country.