As far as the medicaid expansion, I don't really see that doing much at least here in GA because first of all your assetts can not be over $2,000. So basically you cannnot own a home and you cannot have much more than a junker car. Another problem is that very few doctors even accept Medicaid so the people that do qualify for it are left going to the emergency rooms for treatment. I don't see anything in this bill that proposes any solutions to the problems and I think progressives like Lewiston dont even understand the problem in the first place.

I thought it was a damn shame that the outsiders, the bloggers/activists, etc.. accepted at the onset the notion that Medicare could not be expanded upon.  That they shouldn't be pushing for precisely that.  Now, I don't mean universal Medicare day one, but pushing for Medicare to be expanded as the primary solution to health care finance.  I mean, Medicare is the 800 pound gorilla in the room.  You simply can not expect to be an effective activist if you consider national policy debates through the confines of what Congress tells you is possible.  You may as well hang up your hat right their.  That isn't the job of activists.  

But even though the bill is not perfect, for the first time in our nation's history we will have enshrined into law the notion that everybody ought to have health insurance -- and that's a major accomplishment.

He seems to believe the notion that people who do not have insurance don't because they don't think they ought to have it. I know that is true of many young people, but probably not even as many as urban mythology has it. At the bottom of their decline to get it is the expense of it, not the idea that they ought not.

"(p)atient's bill of rights on steroids" is one of Obama's favorite ways to describe something that we have no idea if it will be able to be enforced to any measurable degree.

"(c)overs virtually every American citizen" is important on two fronts: one, undocumented workers are prohibited from buying even unsubsidized insurance through the exchanges, which will guarantee that health care for a large number of individuals will be passed on to the taxpayers and two, it avoids the truth that coverage, in and of itself, does not equate to care.

"(t)he middle class will be entirely dependent on a system of for-profit medicine" isn't just a truth, it's a truth that represents a medical and financial death sentence for too many people, and our fearless leaders have accepted that as an acceptable trade-off for handing the industry a huge and guaranteed windfall.

As for what we are enshrining into law, it would have been far more historic, and would represent a far greater accomplishment, if we were enshrining into law the notion that everybody ought to have health CARE.

And if it can't, how can we justify continuing to embrace and, in fact, prop up, such a system?

We have decades of experience that says the answer to the first question is "no," yet, we have just passed "reform" that prioritizes maintaining the for profit system over providing affordability and access to care.

Broader, more affordable and comprehensive coverage is what was promised in the 1970s when insurers were encouraged to "manage" care and for profit insurers entered the health care market.

What we got instead was less coverage at higher cost, fewer employers able and willing to finance coverage for their employees, and millions of people without affordable access to any kind of coverage or care.

If insurers can't, as they claim, profitably provide coverage now without shrinking benefits, raising premiums and limiting access, how will they be able to maintain profitability when it is more difficult for them to manage risk by denying coverage (for pre-existing conditions, for instance), limiting benefits, limiting lifetime payouts, etc., etc.?

The simple answer is they won't be able to do so. And we won't actually be asking them to do so.

Your political objection is to the universal mandate, but that was the best we were going to get from Obama. He did not campaign on it, but it was clear to all informed observers that he would have to add a mandate for his plan to work at all.

Here's a bit of history - now nostalgia:

"[A]ny plan I sign must include an insurance exchange: a one-stop shopping marketplace where you can compare the benefits, cost and track records of a variety of plans - including a public option to increase competition and keep insurance companies honest - and choose what's best for your family."

What flipped him?

Some relevant info from the article in the NY Times:

"Several hospital lobbyists involved in the White House deals said it was understood as a condition of their support that the final legislation would not include a government-run health plan paying Medicare rates -- generally 80 percent of private sector rates -- or controlled by the secretary of health and human services. "We have an agreement with the White House that I'm very confident will be seen all the way through conference," one of the industry lobbyists, Chip Kahn, director of the Federation of American Hospitals, told a Capitol Hill newsletter..."

"Representative Henry A. Waxman,..., said the president had personally assured House members that he did not intend to let the Senate Finance Committee determine the final legislation. "This is going to be a genuine conference with give and take," Mr. Waxman said. "The president has said that personally to the senators, and he has said it personally to us." He added: "The president has said he wants a public option to keep everybody honest. He hasn't said he wants a co-op as a public option." Still, industry lobbyists say they are not worried. "We trust the White House," Mr. Kahn said. "We are confident that the Senate Finance Committee will produce a bill we fully can endorse."

--I'd hate to think it was all just...fashion.

Turns out for many of them it was just fashion; easily rationalized posturing. Get yer steaming hot talking points right here.

You know what's really sad? Rahm was right. For too many it was nothing but ultimately meaningless progressive posturing. Call them names. lie to them, kick sand in their faces and they will eventually get right back on board the establishment train every time. You don't even have to apologize or give them an inch. It's...inevitable. That's why they can be ignored.

He must be having a belly laugh at the expense of the reliably wilting segment of the "left of the left". He called it. From this point on I'm sure the party blogs are going to wield way scary influence on legislation and the WH.

I mean, talk about insuring your own marginalization. By successfully fulfilling establishment prophecy they have essentially rendered themselves go along to get along impotent. The next time the progressive threats fly it will be met with a condescending smile, if it's even acknowledged at all.

Establishment: The progressive bloggers want what? Oh, aren't they just so adorable when they stamp their wittle fingers on their wittle keyboards and make their wittle demands. Why, they may even make some fiercely empty threats and send us sternly worded letters! We're so scared!

Party/politicians over good policy isn't progressive activism, it's establishment cheerleading and it's a real credibility killer. That is, unless these bloggers are basing their credibility on rollover party line "pragmatism" when push finally comes to shove. If that's the case - major props.

Two reasons:

1. They got played; and/or

2. They got funded.

Jane Hamsher finally caught up with the story yesterday.

There's something wrong with journalism and our newsmedia in general when a smoking gun like ObamaRahma's dirty deal to never let the PO see the light of day as long ago as last June 2009 has been floating around unnoticed -- even in broad daylight on the front page of the Times last August -- when the PO feature of the HCR was so popular with the public and Obama was raising money on it and moving along this corporate HCR boondoggle with the help of the PO ("to keep insurers honest") we all thought was contained within it -- but it wasn't! Except as a pretense that Obama knew all along would  disappear. Like watching a magician doing a shell game -- PO, PO, where's the PO? -- where's the outrage?

Why is this not a major scandal at the core of the HCR drama? Is Obama being protected that much?

Here's the sequence of stories since last Aug 2009:

Original NYT piece + 3 Huffpo articles:

1)  August 12, 2009: Obama taking active role in HCR talks
http://www.nytimes.com/2009/08/13/health/policy/13health.html?_r=1&sq=Chip%20Kahn%20Baucus%20pub lic%20option&st=sce&srp=2&pagewanted=all

2)  October 26, 2009: Who's killing the public option?
http://www.huffingtonpost.com/miles-mogulescu/whos-killing-the-public-o_b_334372.html

3)  March 12, 2010: Obama, Durbin and Pelosi all point fingers at someone else for who killed PO
http://www.huffingtonpost.com/miles-mogulescu/obama-durbin-and-pelosi-a_b_497359.html

(WOW Murray State!!!!)

So while President Clinton was pushing for employers to cover their workers in his 1993 bill, John Chafee of Rhode Island, along with 20 other GOP senators and Rep. Bill Thomas of California, introduced legislation that instead featured an individual mandate. Four of those Republican co-sponsors . Hatch, Charles Grassley of Iowa, Robert Bennett of Utah and Christopher Bond of Missouri . remain in the Senate today.

So it does appear that 1993 Republicans HCR bill was more progressive than Bill Clintons.  Also from the article, the Obama HCR bill is very similar to the one Republicans proposed in 1993.  More evidence the Republicans in 1993 were more progressive than Bill Clinton.

But the summary of the Republican bill from the Clinton era and the Democratic bills that passed the House and Senate over the past few months are startlingly alike.
Beyond the requirement that everyone have insurance, both call for purchasing pools and standardized insurance plans. Both call for a ban on insurers denying coverage or raising premiums because a person has been sick in the past. Both even call for increased federal research into the effectiveness of medical treatments . something else that used to have strong bipartisan support, but that Republicans have been backing away from recently.

The industry, as we'd expect, is going to fight the provisions it doesn't like. Their argument is going to be straight-forward: we can't afford the costs of insuring high risk individuals without increasing premium costs to the young and the healthy.

We live in a place with a mix of private and public insurance, where having some form of insurance is mandatory. Costs are continuing to rise for public sector insurance faster than private sector insurance, mostly because of the government's commitment to providing fairly high quality services to people everyone, including dental.

The gold standard for medical expertise is 'trained in the USA'. Other countries provide first class training and expertise. But the for-profit system in the US drives the innovation that keeps producing new drugs and procedures. More socialized systems copy the innovation of US private industry.

The US continues to be the world leader in medical research. I don't know enough about the bill to say this innovation is at risk, but I can't see how the system is going to be cover low-income high risk clients without a major increase in costs.

This legislation could be the best thing that ever happened to India's pharmaceutical industry. Cost if Dems think they can kneecap the health-industry and the insurance companies and try to compel businesses to cover the poor from corporate profit Dems really are delusional.