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The Progressive case to vote for the Senate Healthcare bill

physician thinking I’m still not sold on this Senate healthcare bill. I think it is a sorry excuse of a bill. Yet there are a few good things still in the bill that I can support. Here’s one point of view.

FromThink Progress:

Since Joe Lieberman demanded stripping the public option and Medicare buy-in provisions from the merged Senate bill, some strong progressives like Howard Dean have argued that without a public option or a Medicare buy-in provision, the bill is a giveaway to private insurers and should be killed. Other progressive leaders like Senators Jay Rockefeller, Tom Harkin and Sherrod Brown believe that the bill represents the best chance for passing health care reform in the foreseeable future. “I’m going to vote for it,” Brown told reporters. “I can’t imagine I wouldn’t. I mean there’s too much at stake.”

Change of the magnitude envisioned by health care reformers does not come easily. There have been many frustrations and there will be more. But, as a senior White House staffer with a ringside seat for the slow death of comprehensive care in 1994, I am keenly aware of the real alternative to the bills now before us: millions more Americans without health care and billions more for health care spending as the same challenges President Clinton tried to resolve continue to metastasize unchecked.

So while I have great respect for Governor Dean, and we have worked together to provide the strongest health care reform bill for the American people, I come down on the side of the Senate passing the bill.

Here’s why:

The Senate health care bill is not without its problems. But if enacted, it would represent the most significant public reform of our health care system that Congress has passed in the 40 plus years I have worked in politics. The bill will give health care coverage to a record 31 million Americans who are currently uninsured, lay a foundation that will begin to lower costs for millions of families, and provide all Americans with the access to adequate and dependable coverage when they need it most.

All of us are anxious to see the final language from the Senate. And a final bill must ensure that the subsidies provided are sufficient to make insurance truly affordable for working families. But based on what we know, here are my top ten reasons for why progressives should support the Senate passing the bill:

1. Largest Expansion Of Coverage Since Medicare’s Creation: Thirty-one million previously uninsured Americans will have insurance.

2. Low/Middle Income Americans Will Not Go Without Coverage: For low-income Americans struggling near the poverty line, the bill represents the largest single expansion of Medicaid since its inception. Combined with subsidies for middle income families, the bill’s provisions will ensure that working class Americans will no longer go without basic health care coverage.

3. Insurance Companies Will Never Be Able to Drop or Deny You Coverage Because You Are Sick: Insurers can no longer deny coverage because of a pre-existing condition. They can’t rescind coverage or impose lifetime or annual limits on care. Significantly, the bill also ends insurer discrimination against women — who currently pay as much as 48% morefor coverage than men — and gives them access preventive services with no cost sharing.

4. Lowers Premiums For Families: The Senate bill could lower premiums for the overall population by 8.4%. For the subsidized population, premiums would decrease even more dramatically. According to the CBO, “the amount that subsidized enrollees would pay for non-group coverage would be roughly 56 percent to 59 percent lower, on average than the nongroup premiums charged under current law.”

5. Invests in Keeping People Healthy: The bill creates a Prevention and Public Health Fund to expand and sustain funding for public prevention programs that prevent disease and promote wellness.

6. Insurers Can’t Offer Subprime Health Care: Insurers operating in the individual and small group markets will no longer sell subprime policies that deny coverage when illness strikes and you need it most. Everyone will be offered an essential benefits package of comprehensive benefits.

7. Helps Businesses Afford Coverage: Small employers can take advantage of large risk pools by purchasing coverage through the bill’s state-based exchanges. Employers with no more than 25 employees would receive a tax credit to help them provide coverage to their employees. The bill also establishes a temporary reinsurance program for employers providing coverage to retirees over the age of 55 who are not eligible for Medicare.

8. Improves Medicare: The bill eliminates the waste and fraud in the Medicare system, gets rid of the special subsidy to private insurers participating in Medicare Advantage and extends the life of the Medicare trust fund by 9 years. It also closes the doughnut hole that affected 3.4 seniors enrolled in Medicare Part D in 2008.

9. Reduces The Deficit: Not only would the bill expand coverage to 30 million Americans without adding to the nation debt, it would also reduce the deficit by up to $409 billion over 10 years.

10. Reduces National Health Spending: A CAP-Commonwealth Fund analysis concludes the bill could reduce overall spending by close to $683 billion over 10 years – with the potential to save families $2,500. Even the most conservative government estimates conclude that the bill would reduce national health care expenditures by at least 0.3% by 2019.

Let's not kid ourselves about what's happening

While there are some Americans who truly believe that a single-payer option to healthcare is a bad thing, that isn’t the mainstream. I don’t even think that most Republicans really believe this. Now the debate has turned into something else. Obama has fumbled the ball. He thought that by having an open process and talking to industry first that they were not going to send the attack dogs after him and his plan. Wrong. He thought that he could reason his way to bipartisanship. Wrong.

Progressives have for the most part sat on the sidelines. It is time to get in the ball game. It is time for progressives to quit watching right wing activists push their agenda.
Frank Lutz, Republican strategist, was open and honest about the strategy that Republicans needed to use in order to turn the debate in their favor. The goal was to convince Americans who really want healthcare reform, that they don’t really want healthcare reform. Here are Lutz’s 10 strategic points —
(1) Humanize your approach. Abandon and exile ALL references to the “healthcare system.” From now on, healthcare is about people. Before you speak, think of the three components of tone that matter most: Individualize. Personalize. Humanize.
(2) Acknowledge the “crisis” or suffer the consequences. If you say there is no healthcare crisis, you give your listener permission to ignore everything else you say. It is a credibility killer for most Americans. A better approach is to define the crisis in your terms. “If you’re one of the millions who can’t afford healthcare, it is a crisis.” Better yet, “If some bureaucrat puts himself between you and your doctor, denying you exactly what you need, that’s a crisis.” And the best: “If you have to wait weeks for tests and months for treatment, that’s a healthcare crisis.”
(3) “Time” is the government healthcare killer. As Mick Jagger once sang, “Time is on Your Side.” Nothing else turns people against the government takeover of healthcare than the realistic expectation that it will result in delayed and potentially even denied treatment, procedures and/or medications. “Waiting to buy a car or even a house
won’t kill you. But waiting for the healthcare you need – could. Delayed care is denied care.”
(4) The arguments against the Democrats’ healthcare plan must center around “politicians,” “bureaucrats,” and “Washington” … not the free market, tax incentives, or competition. Stop talking economic theory and start personalizing the impact of a government takeover of healthcare. They don’t want to hear that you’re opposed to government healthcare because it’s too expensive (any help from the government to lower costs will be embraced) or because it’s anti-competitive (they don’t know about or care about current limits to competition). But they are deathly afraid that a government takeover will lower their quality of care – so they are extremely receptive to the anti-Washington approach. It’s not an economic issue. It’s a bureaucratic issue.
(5) The healthcare denial horror stories from Canada & Co. do resonate, but you have to humanize them. You’ll notice we recommend the phrase “government takeover” rather than “government run” or “government controlled” It’s because too many politician say “we don’t want a government run healthcare system like Canada or Great Britain” without explaining those consequences. There is a better approach. “In countries with government run healthcare, politicians make YOUR healthcare decisions. THEY decide if you’ll get the procedure you need, or if you are disqualified because the treatment is too expensive or because you are too old. We can’t have that in America.”
(6) Healthcare quality = “getting the treatment you need, when you need it.” That is how Americans define quality, and so should you. Once again, focus on the importance of timeliness, but then add to it the specter of “denial.” Nothing will anger Americans more than the chance that they will be denied the healthcare they need for whatever reason. This is also important because it is an attribute of a government healthcare system that the Democrats CANNOT offer. So say it. “The plan put forward by the Democrats will deny people treatments they need and make them wait to get the treatments they are allowed to receive.”
(7) “One-size-does-NOT-fit-all.” The idea that a “committee of Washington bureaucrats” will establish the standard of care for all Americans and decide who gets what treatment based on how much it costs is anathema to Americans. Your approach? Call for the “protection of the personalized doctor-patient relationship.” It allows you to fight to protect and improve something good rather than only fighting to prevent something bad.
(8) WASTE, FRAUD, and ABUSE are your best targets for how to bring down costs. Make no mistake: the high cost of healthcare is still public enemy number one on this issue – and why so many Americans (including Republicans and conservatives) think the Democrats can handle healthcare better than the GOP. You can’t blame it on the lack of a private market; in case you missed it, capitalism isn’t exactly in vogue these days. But you can and should blame it on the waste, fraud, and abuse that is rampant in anything and everything the government controls.
(9) Americans will expect the government to look out for those who truly can’t afford healthcare. Here is the perfect sentence for addressing cost and the limited role for government that wins you allies rather than enemies: “A balanced, common sense approach that provides assistance to those who truly need it and keeps healthcare patient-centered rather than government-centered for everyone.”
(10) It’s not enough to just say what you’re against. You have to tell them what you’re for. It’s okay (and even necessary) for your campaign to center around why this healthcare plan is bad for America. But if you offer no vision for what’s better for America, you’ll be relegated to insignificance at best and labeled obstructionist at worst. What Americans are looking for in healthcare that your “solution” will provide is, in a word, more: “more access to more treatments and more doctors…with less interference from insurance companies
and Washington politicians and special interests.”

Progressives have for the most part sat on the sidelines. It is time to get in the ball game. It is time for progressives to quit watching right wing activists push their agenda.

Frank Lutz, Republican strategist, was open and honest about the strategy that Republicans needed to use in order to turn the debate in their favor. The goal, was to convince Americans who really want healthcare reform, that they don’t really want healthcare reform. Here are Lutz’s 10 strategic points

(1) Humanize your approach. Abandon and exile ALL references to the “healthcare system.” From now on, healthcare is about people. Before you speak, think of the three components of tone that matter most: Individualize. Personalize. Humanize.

(2) Acknowledge the “crisis” or suffer the consequences. If you say there is no healthcare crisis, you give your listener permission to ignore everything else you say. It is a credibility killer for most Americans. A better approach is to define the crisis in your terms. “If you’re one of the millions who can’t afford healthcare, it is a crisis.” Better yet, “If some bureaucrat puts himself between you and your doctor, denying you exactly what you need, that’s a crisis.” And the best: “If you have to wait weeks for tests and months for treatment, that’s a healthcare crisis.”

(3) “Time” is the government healthcare killer. As Mick Jagger once sang, “Time is on Your Side.” Nothing else turns people against the government takeover of healthcare than the realistic expectation that it will result in delayed and potentially even denied treatment, procedures and/or medications. “Waiting to buy a car or even a house won’t kill you. But waiting for the healthcare you need – could. Delayed care is denied care.”

(4) The arguments against the Democrats’ healthcare plan must center around “politicians,” “bureaucrats,” and “Washington” … not the free market, tax incentives, or competition. Stop talking economic theory and start personalizing the impact of a government takeover of healthcare. They don’t want to hear that you’re opposed to government healthcare because it’s too expensive (any help from the government to lower costs will be embraced) or because it’s anti-competitive (they don’t know about or care about current limits to competition). But they are deathly afraid that a government takeover will lower their quality of care – so they are extremely receptive to the anti-Washington approach. It’s not an economic issue. It’s a bureaucratic issue.

(5) The healthcare denial horror stories from Canada & Co. do resonate, but you have to humanize them. You’ll notice we recommend the phrase “government takeover” rather than “government run” or “government controlled” It’s because too many politician say “we don’t want a government run healthcare system like Canada or Great Britain” without explaining those consequences. There is a better approach. “In countries with government run healthcare, politicians make YOUR healthcare decisions. THEY decide if you’ll get the procedure you need, or if you are disqualified because the treatment is too expensive or because you are too old. We can’t have that in America.”

(6) Healthcare quality = “getting the treatment you need, when you need it.” That is how Americans define quality, and so should you. Once again, focus on the importance of timeliness, but then add to it the specter of “denial.” Nothing will anger Americans more than the chance that they will be denied the healthcare they need for whatever reason. This is also important because it is an attribute of a government healthcare system that the Democrats CANNOT offer. So say it. “The plan put forward by the Democrats will deny people treatments they need and make them wait to get the treatments they are allowed to receive.”

(7) “One-size-does-NOT-fit-all.” The idea that a “committee of Washington bureaucrats” will establish the standard of care for all Americans and decide who gets what treatment based on how much it costs is anathema to Americans. Your approach? Call for the “protection of the personalized doctor-patient relationship.” It allows you to fight to protect and improve something good rather than only fighting to prevent something bad.

(8) WASTE, FRAUD, and ABUSE are your best targets for how to bring down costs. Make no mistake: the high cost of healthcare is still public enemy number one on this issue – and why so many Americans (including Republicans and conservatives) think the Democrats can handle healthcare better than the GOP. You can’t blame it on the lack of a private market; in case you missed it, capitalism isn’t exactly in vogue these days. But you can and should blame it on the waste, fraud, and abuse that is rampant in anything and everything the government controls.

(9) Americans will expect the government to look out for those who truly can’t afford healthcare. Here is the perfect sentence for addressing cost and the limited role for government that wins you allies rather than enemies: “A balanced, common sense approach that provides assistance to those who truly need it and keeps healthcare patient-centered rather than government-centered for everyone.”

(10) It’s not enough to just say what you’re against. You have to tell them what you’re for. It’s okay (and even necessary) for your campaign to center around why this healthcare plan is bad for America. But if you offer no vision for what’s better for America, you’ll be relegated to insignificance at best and labeled obstructionist at worst. What Americans are looking for in healthcare that your “solution” will provide is, in a word, more: “more access to more treatments and more doctors…with less interference from insurance companies and Washington politicians and special interests.”

As talking point number nine points out, Republicans never wanted to negotiate in a bipartisan fashion or in good faith. Instead, they wanted to keep the status quo. It is in the best interest of insurance companies, pharmaceutical companies and some major hospitals to keep the status quo.

This ship called Healthcare Reform has taken a number of hits. It is listing to the side and is clearly taking on water. As progressives, I don’t think that we can afford to lose this battle. I think that President Barack Obama’s agenda will be dead in the water if he loses this battle. We need to regain the passion that we had in November. We need to fix the ship and point it in the right direction — a single-payer option. We need to sell it as Medicare for all. This will be the safety net that will prevent millions of bankruptcies. We need to come up with a viable way of paying for this program. This will take more than a little bit of magic. Where’s Merlin when you need him?