If you have "no place to go," come here!

Young Ezra's money quote on cost savings under so-called "public option" plans: "All these are speculative"

But read on for an even better quote:

There are at least four ideas in the health-care reform debate that have the potential to deliver on long-term savings. Mankiw does not make mention, or even reference an awareness, of any of them.

There's the theory that comparative effectiveness review -- particularly when combined with a new IT infrastructure that could eventually help guide physician decisions -- will cut down on unnecessary treatments and allow us to bring high-spending regions of the country into sync with their low-spending brethren.

That's those assholes from Dartmouth with the study that doesn't control for sickness in the population when looking for variations in cost.

There's the idea that the Independent Medicare Advisory Council will be the locus for a continual process of Medicare reform that will begin to bring down costs in the Medicare program, and also create a sort of "best practices" laboratory where experiments can be attempted and the best efforts can be further developed.

That's the Council that's going to be stacked with health insurance types who define "best practice" in terms of their profit margins.

There's the argument for the public plan, and in particular the public plan with Medicare powers, that implies that a large purchaser in the center of the system could bargain better discounts with providers.

That's the bait and switch plan with only 9 million customers.

There's the argument that the health insurance exchange will grow to become the primary insurance market and that as insurers begin competing on grounds of cost and quality -- as opposed to risk selection -- that efficiencies will emerge and spending will drift downward, and over time, the employer-based market, which is responsible for many of the costly problems in the system, will begin to migrate toward the exchange.

But that depends on the public plan keeping them honest, which it's too weak to do.

All of these are speculative. But that's true for any cost-saving measures that aren't either single-payer or some radical turn toward the free market that rips away subsidies for the poor and benefits for the elderly.


Ezra's still new at the game, isn't he?

Shit like that is why you never, never, NEVER mention single payer!

But we know it works. That's why single payer is the science-based solution.

UPDATE On reflection, what completely blows me away about Ezra's post is that Obama, the Dems, and the Village -- including the "progressives" -- framed the entire health care debate in terms of cost savings. Over and over again. And they labored away -- and were well paid to do so -- and came up with four separate policy options, each of which has been incorporated in their complex, unproven, and Rube Goldberg-esque legislation. And guess what! The result of every single policy option is "speculative." One, two, three, and four. Obama, the Dems, the Village, and the progressives have been painting pictures in the air and waving their hands and can't make their own case using the frame that they themselves fucking chose. This isn't Obama's Waterloo; it's Obama's Charge of the Light Brigade! It's moral and intellectual bankruptcy on a grand scale...

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Submitted by ralphb on

How long must this kabuki dance go on? Sooner or later single payer has just got to leap up and bite them in the ass to get their attention or we're going to wind up with some abject piece of crap for reform.

I hope they take the August recess before getting much further. That will give people in their districts access to them so the push can be made most effectively. Thanks for all you guys do!

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Submitted by chicago dyke on

can we get going on those now? i'm currently caring for two elder not totally healthy people, so it would be hard for me to go, but i'm starting to think what i need to do is wheel dad down to our rep's office, dump him in the lobby, and say, "ok. you don't want us to have single payer? fine. you take care of him." and then walk out. of course i wouldn't do that to dad, but it's a fantasy scenario and i wonder what would happen if a lot of us did that all at once.

Submitted by hipparchia on

that's a good one, it's one of the 198 methods.

Submitted by jawbone on

you might be arrested for "elder dumping" or something. Seriously. Power can be really imaginiative when it comes to finding ways to harrass those who demonstrate.

But, with an actor and camera.... Or able-bodied non-actor playing an ill, wheelchair-bound elder??

Sick-ins on the steps of congress persons' offices might work better, but we need numbers. Apathy and hopium, ironically, seem to be demotivating people to act in their own best interests.

BTW, my doctor and I discussed health care reform yesterday during my visit, and he told me I am very much in a minority when it comes to seriously thinking about what needs to be done, much less letting the Congress Critters know what I think.

He's pretty sure it's going to get worse before it gets better....

Submitted by lambert on

My fantasy, too. Thing is, you've got to be in "nothing to lose" mode to want to, well, give your life that way.

As I'm sure you know, the process of care overwhelms, and dad would need to want to be involved in this.

Maybe in front of local congressional offices? With our own cameras?

Submitted by jawbone on

something. I have a feeling he's being told it should not happen again. Or, he's allowed since he doesn't have much follo of a WaPo followng yet? I have no idea of how much traffic he gets; but Froomkin probably was getting scary traffic so had to have his link removed from the front page, had to be finally removed entirely.... I'm sure Ezra has absorbed that lesson well.

I just googled for covergage of Wendell Potter, the former CIGNA PR exec, and his damning testimony against the Big Insurers. In the first three pages, a brief mention on ABC news, then on 7/19, C&L posted about the first MCM* interview with Potter -- by Ed Schultz. Video available.

The MCM does respond to power: Obama says single payer is off the table? Nothing gets covered (unless it's done mockingly or to show that DFH's are not cooperating with Obama).

But, really, given the story Potter has to tell, it's stunning he's being ignored. Where's 60 Minutes? Where are the other networks? This is a great American story.

Sounds like a Downing Street Memo....

*MCM--Mainstream Corporate Media

Submitted by lambert on

There's your headline and your framing. Now grab that transcript and make the post...

DCblogger's picture
Submitted by DCblogger on

there was a wheel chair protest in California. It might be effective for care givers to wheel in those healthy enough to be moved and just sit in a congressional office for a few hours. Esp. if you could get three or four people in wheel chairs. Don't get arrested, can't take that chance with the frail, but just sit there a few hours. It would have an impact, esp. if it began to happen all over the country.