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Pelosi's brand spanking new slogan for the recess

Way too little, way too late:

Pelosi provided House Democrats with talking points to take back to their districts. The headline — "Health Insurance Reform to Hold Insurance Companies Accountable" — showcased Democrats' stepped-up efforts to cast insurance companies as villains in the debate, as polls show a public increasingly wary of the health care effort.

Sweet Jeebus.

Even a simple soul like me knows that you can't just switch on populist rhetoric like a light switch. You've got to prepare the ground in some way!

Anyhow, "holding the insurance companies accountable" is a vacuous slogan no matter what. Voters can hold their elected representatives accountable through elections, one hopes, but people can't hold insurance companies accountable through the market* because the market is broken. Krugman the economist:

There are two strongly distinctive aspects of health care. One is that you don’t know when or whether you’ll need care — but if you do, the care can be extremely expensive. The big bucks are in triple coronary bypass surgery, not routine visits to the doctor’s office; and very, very few people can afford to pay major medical costs out of pocket.

This tells you right away that health care can’t be sold like bread. It must be largely paid for by some kind of insurance. And this in turn means that someone other than the patient ends up making decisions about what to buy. Consumer choice is nonsense when it comes to health care. And you can’t just trust insurance companies either — they’re not in business for their health, or yours.

This problem is made worse by the fact that actually paying for your health care is a loss from an insurers’ point of view — they actually refer to it as “medical costs.” This means both that insurers try to deny as many claims as possible, and that they try to avoid covering people who are actually likely to need care. Both of these strategies use a lot of resources, which is why private insurance has much higher administrative costs than single-payer systems. And since there’s a widespread sense that our fellow citizens should get the care we need — not everyone agrees, but most do — this means that private insurance basically spends a lot of money on socially destructive activities.

The second thing about health care is that it’s complicated, and you can’t rely on experience or comparison shopping. (“I hear they’ve got a real deal on stents over at St. Mary’s!”) That’s why doctors are supposed to follow an ethical code, why we expect more from them than from bakers or grocery store owners.

You could rely on a health maintenance organization to make the hard choices and do the cost management, and to some extent we do. But HMOs have been highly limited in their ability to achieve cost-effectiveness because people don’t trust them — they’re profit-making institutions, and your treatment is their cost.

Between those two factors, health care just doesn’t work as a standard market story.

Now, the argument now doubt is that the bills on offer will provide "tough regulations" for the insurance companies. But the tip-off is the weakness of the ombudsmen in the bill; they have no conflict resolution powers. So how and to whom do patients appeal?

So, prepare yourselves for reams of "progressive" bloviation on the Democrat's new found spine, etc. Yay!

NOTE * An odd locution anyhow....

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Submitted by jawbone on

they can only hold politicians accountable that way. And with the flam-flam-flammery and bamboozlement coming out of the WH and Congress, it's hard for those not paying really close attention to holdeven realize which politicians let them down. Any backlash will be applied to any and all pols within reach of the voters' anger.

I'm listening to Nancy Pelosi on NewsHour and hearing completely unrememberable pabum. She's for health, wellness. Good grief! It's all good!

If Dems had used the clear cut arguments of TR, FDR, Truman, JFK, LBJ, they would have the ground prepared for moving the people, appealing to their sense of fairness and self-presevation, but as it is they're now trying to play Obama's word games -- and it's not going to go over well. He's never clear and concrete; he's got Dems acting like that. Mush mouthing nonarguments.

If any Dems do say anything down to earth, they get pushed away from the dining room in case their arguments get on the table.

People might notice they're being screwed in favor of Big Business.

NPR reported tonight that Obama is saying "health insurance reform" over and over to reassure people who supposedly love their Big Insurance Parasites and don't want to lose their insurance. So, no, Pelosis cannot make the argument that BIPs are the problem; Obama's already made them the delivery system of any care the people will get and he will somehow improve the broken system by his personal magic. Or ...or...something...

The wording is so weak bcz what Obama is getting the Dem legislators to do is pamper the parasites and say a of lot of sweet nothings about keeping the BIPs honest and accountable. Yeah, they'll be accountable -- to their shareholders and Wall Street. BIP stocks ain't going up for nothing.

And Pelosi has clearly ceded the high ground to Obama: She doesn't even talk about health CARE reform. Damn, we are fucked Fucked, fucked, fucked.

Submitted by lambert on

I meant to write "their elected representatives accountable" through elections, not "insurance companies."

Otherwise... Just disgusting. How did we start out with "health care reform" and end up with "reform" that reinforces the insurance companies?

Submitted by jawbone on

all along. It was their goal; they reached it. Success, for them and the BIPs.

(Wall Street is happy so far; armageddon concerning BHIP privatization and profitability has been avoided. Looked like there was going to be real change for awhile there. But brave Obama held off the peasants, and the oligarchs will remain to suck the rents until another day.)

Seriously. Initially he was not for any public plan. He had to have a yes dragged out of him when he was asked if he believed health care was a right. It was like pulling teeth; very uncomforable to watch. He may be a tad more stringent than he meant to be since he's going with the universal mandates. Not universal health care.

Again my prediciton: "Unfunded mandates" will be a major war cry from the opposition, be it Dem, Repub, or whatever, in both 2010 and 2012.

(WNET is broadcasting Pete Seeger's 90th Birthday Concert. Enough to make me cry, listening to all those now old voices still strongly singing for change...and whadda we got??)

Submitted by jawbone on

I thought you have some 111th-dimension stuff going on....

(Dave Matthews, one of the younger voices, sang a his own interpretation of Rye Whiskey--

Rye whisky, rye whisky,
Rye whisky, I cry,
If you don't give me rye whisky,
I surely will die.

Joan Baez's voice is showing age--or maybe illness? She always wraps her a scarf around her throat. Some of the crystalline tones are still there, but there's a bit of a waver and some raspiness. Great presence in Jacob's Ladder. Still lovely.)

Valley Girl's picture
Submitted by Valley Girl on

For reasons too complicated to explain, I got off on a total google tear into the weeds for several hours late last eve- healthcare stuff. I was trying to connect some dots...

I DID, however, discover what The Robert Wood Johnson Foundation is about. Gee, it had seemed to have such an innocuous soothing "roll off the tongue" sound to it, when I heard it at NPR.

Don't get me wrong, I am NO fan of NPR, and I only listen to it on the car radio when I'm driving (if I don't have a good audiobook to listen to) because the other choices in this neck of the woods are sports talk (no offense to sports fans) and winger stuff.

So, sorry, I didn't save all the links. And, people at Corrente, who have been thinking and writing about health care issues since forever probably know that The Robert Wood Johnson Foundation is an evil actor in the health care "debate". I just didn't realize that before last eve. It's not that I don't pay attention to the manifold ways "we get screwed", but it's overwhelming to keep track of them all.

Before writing this, I went back to see if I could find a few links that summed up the problem with the RWJF for readers here, but I couldn't.

In part, perhaps the info about NPR and the RWJF from the RWJF site will be helpful, b/c it documents the RWJF grant support for NPR.

http://www.rwjf.org/reports/grr/024065.htm

And, w/o links, but discovered in my adventure into the weeds last eve-

Robert Wood Johnson IV = Johnson and Johnson

Robert Wood Johnson IV = Bush Pioneer

Oh, and an actual link:
http://info.tpj.org/docs/pioneers/pionee...

with this memorable sentence:

Johnson also was a hit when he amused the other big guns by whipping out an elephant gun.

Valley Girl's picture
Submitted by Valley Girl on

for giving me the opening to use in context some of my weedy adventure, from last eve. Just when I was telling myself, well, you didn't get anywhere with that one! And telling myself not to get on such tears again. ;)

Submitted by hipparchia on

funds the dartmouth atlas project, which is a way cool project, but as for the conclusions being drawn from it... you'll notice that some of the other funders have names like aetna and wellpoint and united health...

i do like the story of the elephant gun though.

Valley Girl's picture
Submitted by Valley Girl on

I clicked on your link to your Corrente post (which was before I got here).

Uh, crickey. Okay, I didn't know about the Dartmouth Atlas Project before I read your post, but (and certainly not meaning to be contentious) but this does not sound like a way cool project. What I'm thinking you mean is the collection of the data, not the analysis. On the other hand, (from your post) this seems to discuss the rationale for data collection- choosing populations to sample.

Dartmouth Atlas Frequently Asked Questions:

“How do you ensure some patients were not more severely ill than others?”
“The study only focused on patients who died so we could be sure that patients were similarly ill across hospitals. By definition, the prognosis of all the patients in the cohort was identical – all were dead after the interval of observation. Therefore, variations cannot be explained by differences in the severity of individuals’ illnesses.”

uh- "the cohort was identical" "all were dead after the interval of observation".

Crickey! Anyone's who's dead in a hospital = identical cohort.

I hope you don't think I'm after you for saying "way cool project", and I haven't had time to do read up much. I'm just interested to know more details.

Submitted by hipparchia on

i do data analysis for a living, it's a waaaaaaaay cool project!

the biggest problem is their data interpretation, not the gathering of it, or even the presentation of it. those treatment variations are real, and tracking down the reasons why would be a very worthwhile thing to do.

but yeah, anybody who's dead in a hospital = identical cohort is about as laughable as you can get [which is just one of the many reasons why i say it's their interpretation that sucks]. no way can you expect anybody with that kind of rigidity of thinking to do real analysis.

that was my favorite one, but the other one that cracks me up is that they use billing data, instead of actual treatment data. that's great if you want to track down who's over- or under-billing medicare, but it's a lousy way to compare the effectiveness of different kinds of care. if you lack other data, it's not a bad first step to start identifying places that might be utilizing different treatment regimens, and once you've chosen some likely examples, you could then dig into actual diagnosis and treatment data.

they do some other stuff with their statistical manipulations and modeling that i think are bogus too, but i'd have to have time and computing power [and money, so that i could quit my day job] to dig into it all.

hmmmm, i wonder if could get a grant from rwjf?

Valley Girl's picture
Submitted by Valley Girl on

Krugman said:

But HMOs have been highly limited in their ability to achieve cost-effectiveness because people don’t trust them — they’re profit-making institutions, and your treatment is their cost.

I read that several times, and makes no sense to me. People (even including MDs) hate HMOs b/c they screw patients and docs every which way from sunday. That is why people ahem "don't trust them"... I very much doubt that people who've had to deal with HMOs think to themselves... as the first bat out of the box... gosh I don't trust them b/c they're profit-making institutions.

If someone can explain to me what Krugman is "trying to say here" I'd be most grateful.

Valley Girl's picture
Submitted by Valley Girl on

Maybe I didn't read the "nuance", in terms of the larger context. And maybe it's "academic prose from an economist", and ahem academic prose can be very different person by person and discipline by discipline.

It just sounded so disconnected from real life realities (RLRs)

Anyway, thanks.

gqmartinez's picture
Submitted by gqmartinez on

I never got into Lakoff because he seems to assume his audience (Pibbers) have a solid set of principled positions. I don't agree. But the focus on message over substance can lead to trying to use fancy schmancy language techniques to sell shit sandwiches. Hell Frank Luntz makes a killing doing that for the GOP. Without something concrete to go with the message, what good is the message?

Also, the messaging approach, to me, treats people like fools incapable of understanding anything complex. I reject that full sail.

mass's picture
Submitted by mass on

which is why we are going to force Americans to buy their products. Thanks, Nance. And where do she and Woosley get off? "We already compromised on single payer." Well, who the hell asked you to? Yeah, you already screwed your liberal base, what do want for that, a cookie?

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