T Nation

Socialized Medicine Dead


Hours before President Obama was set to deliver a make-or-break speech on health care reform, a top Senate negotiator conceded the government-run insurance program so dear to the president's supporters cannot pass the Senate.

Sen. Max Baucus, D-Mont., who was trying to hammer out the details of a bipartisan compromise Wednesday with five other senators, announced that he would be moving ahead with or without Republican support.

But he made clear that the so-called "public option" would not be part of any deal with his name on it.

"The public option cannot pass the Senate," Baucus said. "I could be wrong, but it's my belief that the public option cannot pass."

Obama, who plans to address a joint session of Congress at 8 p.m. ET, has indicated he wants a public option, but so far has not said he will demand it. He also has not said he would veto a package that omits a government-run health insurance program.

Baucus' assessment Wednesday afternoon is the latest blow to die-hard supporters of the option.

Baucus, chairman of the Senate Finance Committee, has so far favored a system of non-profit cooperatives instead. A draft plan he outlined Tuesday included the co-ops. Baucus also said Wednesday that a so-called "trigger," which would keep a public option on reserve in case private insurers don't meet certain benchmarks, has not been part of talks -- though analysts have considered the trigger a possible compromise.

The four partisan bills that have passed out of committee in the House and Senate include a public option. But with the plan apparently on the sidelines for Baucus, he said Wednesday he'll be moving forward, putting out a version next week with a mark-up scheduled for the week after that.

He said he still wants and expects Republican support, but that they will not hold him up.

"This is our moment. We've spent many weeks and months on this crucial issue, and now is the time to move forward," he said. "If there are not any (Republicans), I'm going to move forward in any event."

Baucus said earlier he wanted to have a deal to the president before the address, but even though the senators continued to meet that appeared less and less likely.

Watch President Obama's address to a joint session of Congress and the Republican response at 8 p.m. ET on FOX News Channel and FOXNews.com.

But others tried to take the pressure off the time clock. Sen. Kent Conrad, D-N.D., a member of the Gang of Six, said the group wouldn't have any great revelation.

"It isn't 'get it done by 2 o'clock or it's not going to happen.' That's just not the way it works," said.

"There is a sense of urgency but that has to be counterbalanced by the task of getting it done right, not getting it done quickly," added Sen. Ben Nelson, D-Neb.

Obama has spent much of the summer trying to drive back criticism -- loudly on display at town hall meetings across the country -- about government-sponsored health care reforms. He has offered explanations for what the program will not do but so far has said little about what he will insist be in the legislation.

Hopes are he will lay it all out in his address to Congress, still being written but expected to go about 35 minutes.

In an interview that aired Wednesday morning on ABC's "Good Morning America," the president said he doesn't want a package that will add one dime to the deficit nor does he plan to stand on ideology. For him, time is of the essence.

"I think what the country is going to know is exactly what I think will solve our health care crisis, they will have a lot of clarity about what I think is the best to move forward. So the intent of the speech is to A, make sure that the American people know exactly what it is we are proposing, B, to make sure that Democrats and Republicans understand that I am open to new ideas, that not being rigid and ideological, but we do intend to get something done this year," the president said.

But Senate Minority Leader Mitch McConnell said "the only thing bipartisan" about the legislative debate so far is the opposition. He proposed tort reform and changing the way medical malpractice suits are resolved. He said that insurance reforms, like intrastate competition, portability and no exclusions for pre-existing conditions were all areas where the two sides could "rally a broad bipartisan agreement."

White House Press Secretary Robert Gibbs suggested that the Finance Committee could be the key to a deal.

Obama is hopeful that the committee "can get something done in a bipartisan way," Gibbs said.

"I think Senator Baucus has been working with this group of senators for almost a year on getting something out of the committee," Gibbs said. "So obviously we're hopeful that something can get done in that committee. That would obviously be an important milestone in this reform."

On Tuesday, Baucus circulated a proposal that would cost $900 billion over 10 years and guarantee coverage for nearly all Americans, regardless of medical problems. Fees on insurers, drug companies and others in the health care industry would finance tax credits to help expand coverage.

One provision would fine families up to $3,800 for failing to buy health insurance, essentially requiring that everyone have medical coverage, much like the case with car insurance. Obama rejected a mandate, and fines, during his presidential campaign.

Gibbs said Congress is closer than ever to getting something done because the president let the committees write the final product rather than offering a plan of his own, a strategy that ensnared former President Bill Clinton's attempts for reform in 1993.

"I think if representatives and senators and the president listen to the American people, what they are telling them quite clearly is that we have to do something about health care. We have talked about this for decades," Gibbs said.

But it's concern that the president isn't listening to the American people that has Republicans wondering if compromise is within reach.

"I believe it would benefit the country more if Mr. Obama was coming to Capitol Hill to listen instead of to lobby for votes for a health care plan that will end up leading to rationed care, tax hikes and job losses. That's the message I heard from the 5,000 people who came to my town hall meetings in August, and it's a message the president needs to hear too," said Rep. Joe Barton, R-Texas, ranking member of the House Energy and Commerce Committee.

The president will have to contend with more than just conservative Republicans. If he demands a government-run system, he could lose "Blue Dog" fiscally moderate Democrats; if he does not insist on a government option, he may lose liberal Democrats.

"We will have a bill, it will be a good bill that will make sure that all Americans have access to affordable health care, and I believe it will have a public option," said Rep. Jan Schakowsky, D-Ill., a member of the House Energy and Commerce Committee.


I'm reading that there is a plan circulating today that would fine those who don't buy health insurance. Up to $3800 dollars for a family making about $66k.


They've been talking mandates for a while.


i really dont want them to compromise on this. I want the bill scrapped, and a new bill that only deals with tearing down state lines when it comes to insurance competition and tort reform. You know, the two things that virtually everyone agrees will help the situation and were conveniently left out of the bill due to special interests.


Those are two great first steps.


Let's not forget about a tax exemption.


I would really like 3 changes to the law that would make a big difference.

A. Allowing cross state line coverage, as mentioned above.

  1. A change in the rules about preexisting conditions. But in this case I do understand they do not want people waiting to get coverage until they actually get sick, and then dumping it when they are well again. If a person changes insurance, looses insurance because of a job loss, or simply do not have insurance because they did not yet qualify at their employer, those are justifiable reasons, and there should be nothing about preexisting conditions affecting them. But a person choosing not to get insurance until they actually are sick, that is different.

D. Instead of having people opt out of lawsuits, nobody can be a party of a lawsuit in their name unless they opt in. This alone would slash the number of people represented in class action lawsuits, and reduce the crazy income made by the class action lawsuit crooks... uh, I mean lawyers.

Not full tort reform, but a big step in that direction.

I personally have won 2 lawsuits I never even knew I was involved in.


Off subject but if obama supported publicly financed elections wouldnt that make the trial lawyers resistance too tort reform irrelevant? It seems like campaign finance reform has been completely ignored as an issue since he got in office.




What does that mean, exactly? "Tearing down state lines" for insurance competition? Is there a state or federal law that prohibits an insurance provider from offering policies in more than one state? I think the major companies (Blue Cross, State Farm, etc.) offer health insurance in all fifty states already. So what legal change are you proposing, and how exactly will it increase competition and drive down costs?


Yes, you can only buy health insurance in the area where you live ( I believe this is how it works.) Here in LA, you have 8 million people and 3-4 health insurance companies. It allows companies to price gouge since they are only competing with a few other companies.


Insurance is regulated by each state, so you can only buy California-approved insurance in California. But there is nothing that prevents a company incorporated in New York (such as Guardian Insurance) from offering health insurance in California, as long as that company meets the requirements defined by the state board of insurance.

So again, I ask: what is the legal or administrative barrier that this proposal is intending to remove? I mean, it sounds good. I just don't understand what it really means.


My guess is increasing competition, which helps to bring prices down.


Yes, increased competition is part of the picture. However, if you are in a state that requires significant restrictions on insurance, the result will almost invariably be higher costs. However, with the state line restrictions removed, you could shop around for a insurance in a less regulated state that is commensurate with what you want for insurance.

One of the fears of this system is that it will lead to a "race to the bottom" where some state will provide the fewest restrictions on insurance, and everyone will flock to the cheaper insurance from that state and in turn consumers will be damaged by the lack of restrictions.


What do you guys thing about the notion of getting rid of employer provided health insurance?

I mean, no one got health insurance from their employer until the wage-caps during WW2 came about.

If people had to shop for and buy their own policy rather than simply opting into the bulk deal that their employer has cut with an insurance company, don't you think that would force insurance companies to compete to a greater degree as well as reducing overheads and increasing wages and/or dividends?


Socialized medicine isn't dead. This just wasn't it's time, yet.