WASHINGTON -- Keith Olbermann wants to be a martyr, and he wants you to join him.
The host of MSNBC's "Countdown" aired another of his "Special Comment" editorials on healthcare reform Wednesday night, reacting to the latest damage conservative Democrats have managed to inflict on the reform proposals. Many of his points were dead on; the insurance industry has too much clout in Washington, Republicans have contributed nothing to the debate and conservatives in the Senate Democratic caucus have pulled the legislation far to the right. So far, so good.
But like many progressive activists, Olbermann -- furious over what is probably the final death knell of a public insurance option -- has zeroed in on the legislation's mandate that everyone in the country buy insurance. Without a public option, this would mean everyone is required to become a customer of the very insurance industry that has demonstrated its power all year. So Olbermann wants to fight back.
If still the bill and this heinous mandate become law there is yet further reaction required. I call on all those whose conscience urges them to fight, to use the only weapon that will be left to us if this bill becomes law. We must not buy federally mandated insurance if this cheesy counterfeit of reform is all we can buy...
I am one of the self-insured, albeit by choice. And I hereby pledge that I will not buy this perversion of health care reform. Pass this at your peril, Senators, and sign it at yours, Mr. President. I will not buy this insurance. Brand me a lawbreaker if you choose. Fine me if you will. Jail me if you must.
Just like that, in two overwrought paragraphs, Olbermann took his argument down the path of reductio ad absurdum. We must not buy insurance? All year, progressives -- including Olbermann -- have highlighted the endless horror stories from people who don't have health insurance. Barely a month ago, Olbermann was citing, on air, a Harvard Medical School study that found nearly 45,000 Americans die each year because they don't have insurance. Now all of a sudden, he's "calling on all those whose conscience urges them to fight" to voluntarily give the coverage up to make a point?
This is, of course, an easy protest for Olbermann to make -- as he himself clearly recognized, noting that he's one of the self-insured "by choice." Even if he went without whatever insurance he's buying, Olbermann could afford to just write a check to cover the full cost of his medical needs. (And for that matter, the fine he's willing to pay for not having insurance would be only $95 in 2014, though it would rise to $750 by 2016.)
Most of us don't have that luxury, though. Take me, for instance. Even if I was persuaded by his argument, I couldn't join Olbermann's boycott; I've had insulin-dependent, or type 1, diabetes for 22 years. There was nothing I could do to avoid it -- it's genetic. But more important, it's expensive to treat. The insulin infusion pump I wear cost $5,000, which was covered by insurance. The continuous glucose monitor transmitter I also wear was another $2,000, also covered. I check my blood sugar six to eight times a day, using test strips that cost a little more than $1 each; my insurance also pays the full cost of those, because the company realizes it's cheaper to pay for me to check my blood sugar a lot now than to pay for the complications of uncontrolled diabetes later. The insulin I use in the pump would cost between $90 and $110 a vial without insurance, and I go through two or three vials each month. Add in a month's worth of pump infusion sets ($116), reservoirs ($33) and glucose monitoring sensors ($350), and the costs just for managing my diabetes add up to more than $1,000. Then there's the quarterly visits to an endocrinologist, twice-yearly dental checkups, an annual eye exam and a few other prescriptions. Pretty soon, I'm looking at taking on a second mortgage payment each month just to stand on Olbermann's idea of principle. Sure, my insurance premiums and co-pays come to several thousand dollars a year. But even buying insurance on the open market would be cheaper for me than paying for all that stuff out of pocket if I wasn't covered through my wife's employer. Though of course, if the healthcare bill fails, and its insurance industry regulations don't become law, I couldn't buy insurance on the open market anyway, because I have a pre-existing condition.
So the only people, really, who could afford to "use the only weapon left" to protest the healthcare bill along with Olbermann would be healthy people, who don't need insurance to begin with. And those healthy people are also where the argument against the individual mandate begins to fall apart. The reason it's worth swallowing the individual mandate is because that's the only way to make insurance affordable for anyone who might actually get sick and need it. Insurance providers -- whether it's Blue Cross or a federal public option -- need to have some healthy people in their risk pool to offset the costs of the sick people. Otherwise, if they've got to shell out $1,000 a month to keep me alive and more or less healthy, they'd have to charge me at least that much just to stay in business. (Unfortunately, as we all know, they also like to tack a little extra on to pay their CEOs extravagantly.) That's why large employers can afford to insure their workers, and why many small businesses can't -- the risk pools aren't big enough.
One part of the healthcare legislation that pretty much everyone likes is the new regulation forcing insurers to cover everyone, no matter what kind of pre-existing conditions they might have. But without an individual mandate, there won't be enough healthy customers, who are cheap to insure, to balance out all the sick people who would be newly eligible for coverage. Premiums would rise even faster for the people who most need insurance than they already are. In what's known as an insurance death spiral, only the most expensive, sickest patients would remain in the risk pool.
What's galling about the mandate in a bill with no public option, of course, is that it essentially guarantees the insurance industry a steady revenue stream and millions of new customers. That's frustrating -- infuriating, even. But it shouldn't be a deal-breaker. Would there be people, under the reform legislation, who can't afford insurance premiums? Unfortunately, there probably would -- but the answer to that is to increase the federal subsidies, not kill the bill or remove the individual mandate. After all, anyone who might not be able to afford insurance in the future already can't afford it now. It's hard to imagine that there are people who don't have insurance but are holding out only because they don't want to become customers of the private insurance business.
The point of this reform legislation -- as I wrote the other day, and as White House communications director Dan Pfeiffer wrote Wednesday -- should be to expand access to healthcare, which every industrial nation except ours considers a basic human right, not to punish insurance companies for the many, many sins they've committed in the past. Plenty of those other industrial nations require people to buy insurance, the same way this bill would do. Is this the ideal answer to the healthcare system's flaws? No. But is it a decent place to start? Yes. Olbermann should keep that in mind, and push to fix -- not kill -- the healthcare bill. Most of us can't afford to do it his way.
Watch his complete "Special Comment" here:
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Just an update to a bizarre and tragic story you may remember having read about earlier this year, and which left an impression on me I'd rather it didn't. Julie Corey, the woman who in July allegedly killed her eight-months pregnant friend and then cut the live fetus from her womb and kidnapped it, has been formally charged with murder.
After allegedly killing Darlene Haynes by some combination of blunt head trauma and strangulation, Corey showed up at a homeless shelter in New Hampshire claiming to be the excised baby's mother. Corey had apparently been telling friends she was pregnant, but wasn't. It took a few days before authorities finally found Haynes' body in her apartment.
Haynes already had three other children, the eldest two of whom already were living with her mother. Her then-18-month-old and the abducted baby are in custody of Massachusetts childrens services.
It's just such a sad case all the way around--a woman dead, two kids orphaned, and an alleged killer who most likely suffers from some form of mental illness.
No surprise here. Former President Bill Clinton has weighed in on the healthcare reform legislation, and he's in the take-what-you-can-get camp:
Our only responsible choice is the path of action. Does this bill read exactly how I would write it? No. Does it contain everything everyone wants? Of course not. But America can't afford to let the perfect be the enemy of the good.
Full statement over at TPM.
Nebraska Democratic Sen. Ben Nelson, who along with Senators Joe Lieberman (I, CT) and Olympia Snowe (R, ME), remain the key holdouts in the Senate healthcare reform showdown, told a home state radio station today that he was not threatened with a base closure in his home state if he didn't get on board with reform.
Nelson told KLIN/Lincoln radio hosts Jack Mitchell and John Bishop that he knows who started the rumors and when it comes to light it will be "embarrassing for the other side of the aisle," presumably meaning a Republican senator or senators is behind it.
The bad news for Majority Leader Harry Reid and President Obama is that Nelson continues to have problems with the abortion provisions in the bill, and although overtures have been made toward him, he continues to hold firm in his resistance until the abortions provisions he disapproves are stripped away.
As I noted in a previous post today, in response to news of the House's passage of the $174B jobs bill, President Barack Obama used the term "Great Recession." Maybe I have a tin ear, but that was the first time I noticed him using that specific phrase.
Obviously, there was plenty of "worst economic crisis since the Great Depression" usage both during the campaign and even after Obama and Vice President Joe Biden took office. That line seemed to be used at some point in almost every campaign speech--and with cause.
But "Great Recession" is a different semantically, is it not?
For one, the usage not merely invokes directly, but ryhmes with and includes the capitalization of, "Great Depression." (The White House release yesterday capitalized it, making it not merely an adjective-noun combination, but a proper noun.) And, of course, as a rhetorical device it analogizes the magnitude of our present situation to that of the 1930s and 1940s.
In any event, if you do a google search of the White House website for "great recession," there are 14 mentions or references to the term during 9 separate public statements from four different persons: Press Secretary Robert Gibbs, who made first mention back on July 29; White House senior adviser Robert Gibbs; Obama; and, more than any of those three combined, Biden.
Here, as best I can tell (and with thanks to fantastic work by Salon intern Emily Holleman) is the chronology:
July 29, Press Secretary Robert Gibbs:
“We all have watched and we've all heard and read stories -- some of which you all have written -- where the discussion wasn't whether or not we were improving of what have you, but how far -- how much further we could fall; could we go off the edge of that cliff into what some are calling the Great Recession, or as some were betting that we could fall into a depression.” (Press gaggle, Air Force One en route to Bristol, Virginia)
September 3, Vice President Joe Biden:
“President Obama and I, when we entered office, we were in the midst of what I refer to as the Great Recession.” (Remarks on the 200 Days of the American Recovery and Reinvestment Act, Brookings Institute, Washington, DC)
September 22, Biden:
“And even in Michigan, which is being battered now as a consequence of this Great Recession, and Michigan, which was the best--where there was only a 37 percent gap between premium and wages is actually the smallest -- but still a 37 percent gap.” And later: “During this Great Recession, when inflation actually fell .7 percent. Inflation fell .7 percent, and premiums increased 5.5 percent.” (Address to National Association of Insurance Commissioners, Gaylord National Hotel and Convention Center, National Harbor, Maryland)
September 27, President Barack Obama:
“Our entire financial system was poised on the brink of collapse with many fearing that what has been called the Great Recession would become another Great Depression.” (Address to Congressional Black Caucus Foundation's Annual Phoenix Awards Dinner, Walter E. Washington Convention Center, Washington, DC)
October 2, Biden:
“We will recover. And we're determined that when we do, the middle class is in a better position coming out of this than when it went into this Great Recession.” (Remarks on Unemployment Numbers, White House, Roosevelt Room, The White House)
October 30, Biden:
“[The President] termed the Recovery Act the beginning of the end of the Great Recession that we faced. And we called it a Great Recession not to engage in hyperbole; it's the worst recession America has ever faced short of a depression. So unfortunately, it was the greatest--meaning worst-recession we've had in modern American history, short of a depression.” And later: "The reason we're here today is to meet the commitment I made to you all when the President put me in charge of this, to assure the American people that this unprecedented investment in the midst of this Great Recession would be totallytransparent, and we would be accountable for every penny we sent out there; and also to let you know in the first quarter of the reporting, the first report that we're making--and we're going to make subsequent reports--that we in fact --what the progress has been, what has been the consequence of the investment made so far." And later still: "Even if we did not have this Great Recession, we should be investing in this infrastructure." (Vice President "Reports over 1 Million Jobs Created", Washington, DC)
November 9, Biden:
“We want to come out of this Great Recession, and we will come out of it, we will come out if strong, but we want to come out of it with the middle class positioned better in the new economy then [sic] they went in.” (Discussion on Middle Class Families, Center for American Progress, Washington, DC)
November 11, White House senior adviser David Axelrod:
“Asia represents a great emerging market for American products and as we rebuild our economy from this great recession, one of the things that’s going to power it is expanded markets for American products.” (“Axelrod Previews President's Arrival in Singapore,” aboard Air Force One en route to Singapore)
December 16, Obama:
“All over our country this holiday season, Americans who lost their jobs in the Great Recession are looking for work.” (Statement on House Passage of Jobs Bill)
Perhaps I'm making mountains of rhetorical molehills here. But nobody disputes that the term Great Depression is a proper noun. Whether we are in fact living through the Great Recession or not is, I suppose, an arguable proposition. In fact, we won't know until it's over just how "great"--meaning bad, as the VPOTUS might say--it is.
Speaking of Biden, he seems to be particularly fond of dropping the GR. Five of the nine speeches in which it was used belong to him, as do 10 of the 14 total mentions. I presume these are prepared remarks, but I'm not sure; the VPOTUS could be freelancing a bit here.
The White House messengers are correct when they said "Great Recession" is a term used by others first, and thus not of their own making. Back in March, Catherine Rampell conducted an etymological inquiry. She found that the term was used sparingly throughout 2008 but mentions ramped up in early 2009.
In that regard, you could say the White House has been slow and sparing in adopting the term. But this fall the White House--or Joe Biden, at least--seems to be warming to it.
Howard Dean got some prime real estate on today's Washington Post op-ed page to express his dissatisfaction with the healthcare reform bill. He opens with a pretty concise summary of the main objections of liberals and other critics who oppose it for it insufficiencies:
If I were a senator, I would not vote for the current health-care bill. Any measure that expands private insurers' monopoly over health care and transfers millions of taxpayer dollars to private corporations is not real health-care reform. Real reform would insert competition into insurance markets, force insurers to cut unnecessary administrative expenses and spend health-care dollars caring for people. Real reform would significantly lower costs, improve the delivery of health care and give all Americans a meaningful choice of coverage. The current Senate bill accomplishes none of these...
Then, around some suggested changes, he gets to the politics of its passage or rejection:
To be clear, I'm not giving up on health-care reform. The legislation does have some good points...
Improvements can still be made in the Senate, and I hope that Senate Democrats will work on this bill as it moves to conference....
In Washington, when major bills near final passage, an inside-the-Beltway mentality takes hold. Any bill becomes a victory. Clear thinking is thrown out the window for political calculus. In the heat of battle, decisions are being made that set an irreversible course for how future health reform is done. The result is legislation that has been crafted to get votes, not to reform health care.
I'm not convinced that Dean's voice carries as much weight as it once did. Opponents will undoubtedly rally behind him; as a doctor and former presidential candidate who excited key elements of the Democratic base, he lends credibility to critics that those who are dismissing them as looney lefties.
Ezra Klein, who is taking a lot of guff from conservatives while at the same time disappointing liberals for supporting the Senate compromise--calls Dean one of the hostage-takers in the debate:
In his op-ed, Dean names John Kerry as the senator who has been working hardest on this question. This morning, I spoke to Kerry's staff, who got me a statement from Kerry himself. "The prudent purchasing provisions in the Senate health bill will lower costs and increase affordable options for consumers," Kerry says. "It’s strong language that will allow the exchange to deliver competitive prices and offer high quality care, and I’m thrilled to see national reform honor the best innovations already succeeding in Massachusetts.”
I'm sure there's some theoretical way in which the language could be stronger. Dean doesn't say what it is, but I don't doubt it exists. But now we're talking about killing the Senate health-care bill -- with its $900 billion in subsidies and its delivery system reforms and its Medicare Commission and its Medicaid expansion and its exchanges and its regulations on insurers -- unless we make the exchanges slightly stronger prudent purchasers, when they're already strong enough to "thrill" the original sponsor of the prudent purchaser amendment?
I guess this is the logical outcome of a system in which the greatest gains accrue to those making the most credible and severe threats. But it's not healthy.
War Room is written and edited by Alex Koppelman, with contributions from Salon reporters around the country.
