The Most Significant Democratic Triumph in 40 Years

DavidDP

Never mind LBJ, it's been discussed since Teddy Roosevelt.

It's a stunning achievement, and American like winners above all.......

Conservative Cabbie

One can always rely on Alex to find a way to blame this on Republicans. Never mind that the Dems have all three pillars of power, never mind that they have a massive majority in the house, never mind that for over a year they had a super majority in the Senate. Nope, despite all that, the fact that the Democrats have sneaked through by having to use reconciliation, achieving this by a mere handful of votes and 15 months later and this is all the Republicans fault.

Come on alex. Be honest. In Jan 09, did you ever think they wouldn't achieve this?

And as for an achievement - is like those other Democratic achievements: social security, medicare and medicaid? The three unfunded pillars of government expense that have resigned America to perpetual deficit. By all means celebrate another entitlement that has the net effect of insuring only eight million americans whilst spending trillions. That's the progressive legacy.

ndm

I think the most significant event since the Republican victory in the MA Senate race was the imbecilic decision by WellPoint to increase health insurance rates by 39% in the middle of a healthcare reform debate. This gave Obama an easy avenue to go to the public and ask with no easy answer how many years of 40% increases can you afford?

ndm

Andrew Sullivan writes:

-- He still wants to rebuild the American economy from the ground up, re-regulate Wall Street, withdraw from Iraq, win in Afghanistan, get universal health insurance and achieve a two-state solution in Israel/Palestine in his first term.

Unsurprisngly on the day when Obama won a great victory for the American people Melanie Phillips steps up to the plate and writes:

-- Weakening America and strengthening its enemies. Yup, that was all in the prospectus when Obama ran for power. And now we are beginning to see its mortal effects.

Of course, she doesn't care about healthcare she is merely scared shitless that Obama will act like American Presidents should have acted for the last four decades and "achieve a two-state solution in Israel/Palestine in his first term."

Beefeater

"Welfare Reform needed Republican votes."

WF was not only not progressive-inspired, being part of the Republican "Contract with America," the progressives despised Clinton for signing it.

And your view of Healthcare Reform is similarly off-kilter. The "scale" of the Democratic victory is not measured by 40 years of attempts to bring in unpopular health bills, but by the 5 or 6 vote margin it won by. That margin was obtained not just after "arm-twisting" and perseverance by Pelosi, and a lot of number-fudging, but most significantly after the President put his Presidency on the line.

As for the GOP "blunder" of opposing too much, they opposed to the full extent of their opposition minority, using moral and political persuasion in entirely the usual way (except that party discipline was unusually strong, given popular pressure).

The legislation can only be claimed as a monumental achievement by the Democrats and Obama, because the GOP - and much of the country - view it as a monumental error.

Monumental is as monumental does. The "affordable" insurance for all comes at a monumental price. And like all "progressive" social legislation it will exacerbate the problem it seeks to address.

It remains to be seen whether "Repeal and replace" - the new Contract with America - will sweep in Republicans in November.

THX1138

CC I think you'll find that it was one of you're own David Frum who blamed the Republican Party.

He said this on Twitter:

"if HCR prevails, Republicans need an accountability moment. Jim DeMint/ Rush / Beck etc. ed us to Waterloo all right . Ours."

As for the deficit remember 'W' and remind us where it was under Clinton. Of course that doesn't fit the narrative does it! And lets not forget what the NEUTRAL CBO had to say about the costs of HCR.

This a great day for the American people and I hope it gets even better when Rush keeps his promise and flys off in his Gulfstream Jet and leaves America for good. What are the odds on the leader of the Republican party keeping his word?

DavidDP

I take it the Republicans will be calling for immediate withdrawal from Iraq now, given their new doctrine of government by opinion poll.

Conservative Cabbie

THX

David Frum is definitely not "one of my own". Like Charles Johnson and Andrew Sullivan, he is a supposed conservative motivated purely by his own sense of self-importance. There's a reason he changed the name of his website to FRUMforum.

Conservative Cabbie

Alex

I wonder how short term your view of Democratic "success" is. Pelosi is now a dead speaker walking, epublicans now have a shot at getting back the Senate (competitive in Wisconsin, california etc). If both those things happen (control of the house, 51 seats in the Senate), just think how difficult they will make the rest of Obama's Presidency. They will push everything through via reconciliation forcing Obama to veto what will most likely be pre-designed populist bills.

And calling what the Democrats did yesterday a "legislative achievement" is like saying that Hitler was "successful" at population control. True on the face of it but also hopelessly inaccurate.

DavidDP

"There's a reason he changed the name of his website to FRUMforum."

Yeah, like IAIN DALE'S Diary......

THX1138

CC And as for your hero Lady Gaga, what is her motivation then?

Enriching herself on the backs of the sad fat losers who buy into her BS and hate mongering would be my best guess!

This is a GREAT day for America!

DavidDP

"Pelosi is now a dead speaker walking, Republicans now have a shot at getting back the Senate (competitive in Wisconsin, california etc). If both those things happen (control of the house, 51 seats in the Senate), "

Mid-terms were always likely to be difficult for the Democrats (much the same here in the council elections for the Conservatives, for example - they've hit as many seats as they could expect, which means they will likely lose a few at the next locals.), but I don't think it will necessarily be the blood bath forewarned. Not least because the heat will dissipate from the argument, and the more outlandish predictions made by the GOP will not come to pass (their own fault that - a lesson in making proper criticism, not bizarre claims). I'll check on my way into work, but I'm pretty sure the Stars an Stripes is still flying over Congress.

And even if it does, Clinton managed a successful first and then second term despite his awful mid-terms. Finally, I'm sure that both Obama an Pelosi would be settle for this as their legacy. Something no administration has managed despite being proposed for 100 years.

Conservative Cabbie

THX

"This is a great day for America".

Easy to say when you don't live there. Which is the great part? The higher taxes, the extra burden on employers during a recession, the help that Democrats have given to Insurance company profits with all those extra customers, the increased deficit, the additional bureacracy, the damage done to the parliamentary system, the increased cost of health insurance for Americans or the longer waiting lists and lack of Doctor's.

What a strange take on the world you have.

"Lady Gaga". - Intersting ad hominem from a Hollywood liberal. No doubt Madam Botox looks normal to you :-)

Conservative Cabbie

DavidDP

The conservative base is already moving behind Bart Stupak's Nov. opponent. They will be highly motivated with money and support, even more than they already are. And we are already in a situation in which pundits like Charlie Cook are envisaging a GOP takeover of the house, a situation in which Barbara Boxer in California is neck and neck in the polls and the GOP are ahead in the Senate race in Wisconsin. Don't bet on their not being a bloodbath.

"and the more outlandish predictions made by the GOP will not come to pass"

Unemployment is set to rise again (the White House's own estimate) - it's fairly easy to pin that on Obamacare and the increased obligation on benefits. And more to the point, whether or not the more "outlandish" claims of the GOP come to pass, in November and 2012, neither will any of the supposed benefits of Obamacare come to pass either. The voter will be left wondering "where's my healthcare reform?". In the meantime, insurance costs will continue to rise as will taxes and jobs will continue to be lost. An unengaged voter is likely to think "we went through all that for what?"

"Yeah, like IAIN DALE'S Diary....."

That'll be the Obama supporting Iain Dale will it? I rest my case :-)

Dirty Euro

But surely cutting debts is more important keeping working and lower middle class americans alive?
Yeah right!

THX1138

CC For all the hate spat out from Lady Gaga for Hollyweired etc it didn't stop her and the other Wasilla Hillbillies looting the freebie tent at the Oscars did it.. HYPOCRISY!

Where is you dog in this fight, your covered by the NHS are you going to give that up?

Easy for you to keep your ideological purity. Perhaps if you had a child dying of cancer but you had just been laid off & you couldn't afford Insurance premiums yourself, or your wife had a pre-existing condition but an Insurance Co would prefer a better quaterly statement than treating her you might change your view.

At least the American public is getting something for their tax dollars, I'd say most would prefer a decent universal HC system for their money rather than spending a Trillion dollars on a never ending war in the Middle East which was 'W"s legacy to the American people.

Edmund Jerk

I have to say the Republicans' protested too much they never had a leg to stand on after the Big Government fiscal recklessness of the Bush years: medicare etc. Passing a bill that will get -millions-more Americans insured is an achievement and doing it without succumbing to the Left of his party by pushing for an NHS style 'public plan' is a double achievement. Well done Obama and Pelosi.

Augustus

A pyrrhic victory. And a parasitic one on what remains of the wealth-producing sector.

Conservative Cabbie

THX

A Trillion dollars? Big whoopee. HCR will cost tens of trillions over the next few decades.

"Where is you dog in this fight, your covered by the NHS are you going to give that up? "

Gladly if it meant paying lower taxes. The NHS is a laughing stock of poor service, rationed healthcare and terrible outcomes.

"Perhaps if you had a child dying of cancer"

We've had this discussion before. That child has a much greater chance of surviving in the private world of American medicine than in the socialist world of the NHS. Them's the facts.

And I'd much rather the real world of redneck Oklahoma than the fake plastickey world of Hollywood.

Beefeater

Dirty Euro:

You are confusing Healthcare with health and care.

Beefeater

"At least the American public is getting something for their tax dollars"

That remains to be seen. Middle-class entitlements tend to impoverish the middle-class.

THX1138

CC

We could have the best HC in the world if we wanted but I doubt you'll find many/any takers for doubling the amount of the countries wealth we spend on HC.

You'd just pay your tax saving to a far less efficent Insurance Co instead of the state. What is HC insurance but another tax either paid by you or by your employer but paid to a a company rather than the state and look how quickly that tax is rising in the US right now-

"That child has a much greater chance of surviving in the private world of American medicine than in the socialist world of the NHS."

Yes if you have HC Insurance otherwise the queues and the rationing never even starts and the outcomes are awful.

Two weeks in Oklahoma and you'd be gagging to leave I promise you.

ndm

Conservative Cabbie responds to THX:

-- "This is a great day for America".

--Easy to say when you don't live there.

Well I do live there and This is a great day for America.

CC then goes on to ask Which is the great part?

The higher taxes The healthcare number that should matter most to America is the percentage of GDP spent on healthcare. In an ideal world this care would be provided through the private sector but across the globe the private sector has demonstrated itself unwilling and incapable of providing that care. Consequequently, in the US we have Medicare covering all senior citizens. And now since the private health insurers have refused to do so Congress has had to step up to the plate to ensure that healthcare will be available to all Americans. Wellpoint certainly demonstrated that with its decision to raise rates by 39% for many Americans this year - following on from years of 20% rate increases. There is no conceivable tax increase I could face that would match the rate increases I have been subjected to by Wellpoint over the years.

the extra burden on employers during a recession Uh. Because there is no burden on an employer like a worker who can't come into work because he is off sick and can't afford treatment. Perhaps Republicans should think of the recession when they oppose meaningful reforms of the financial services sector that was such a large part of the cause of this recession.

the help that Democrats have given to Insurance company profits with all those extra customers, But surely additional money to the insurance industry is the wet dream of Republicanism. The insurance industry has shown itself to be utterly incompetent and will only seal its doom if it continues is past behavior. It is far better for both the individual and society that everyone has access to healthcare. One of the downsides of the US insurance-based coverage is that those with insurance are isolated to some extent from its cost which has allowed severe inflationary rise in those costs. The insurance industry, far from reigning in those costs, clearly derives great benefit from them since it mush easier to make profits from a 39% rate increase over a 9% cost increase than it is to make profits from a 9% rate increase over a 2% cost increase.

[As an aside - don't give me any bullshit about getting rid of regulation and allowing out-of-state sales. The only benefit of allowing Wellpoint Alabama to compete with Wellpoint California accrues to Wellpoint who will be able to offer 50% of the service for 90% of the price through its Alabama branch. Unsurprisingly, the Republican Party which always puts its perceived interest of American business ahead of the interests of the American people.]

the increased deficit The Republicans lost all right for a generation to discuss the deficit when it took the Clinton surplus along with a raid on the US Treasury and offered "tax cuts" to the American people. Not to mention the unfunded Iraq war and Medicare Part D - and the notorious lies about their cost. Of course, the Obama demonstration is running a big deficit right now - it is after all trying to rescue the economy from years of trashing by George W. Bush - holder of a gentleman's third from Yale and the Worlds premier social-networking qualification a Harvard MBA.

the additional bureacracy Evidently, CC has never tried to deal with an insurance company or even someone who has to deal with an insurance company. I had a minor procedure last year and before it happened all three providers - surgeon, clinic and anesthesiologist - phoned to request I bring a credit card because they were concerned about my high deductible. This is the high deductible that Republicans think all Americans should have because of the bullshit that it would make them more cost conscious. Of course, what it does is stop them having routine care that might prevent a more serious problem later. But then noone can accuse a Republican of being too smart.

the damage done to the parliamentary system This is just plain ignorance. The Senate passes a bill, the House passes the same bill - that is how the system is supposed to work. The alternative that no bill gets passed because members of the Senate Country Club only pass bills collegially if 60 people allow the vote is a fairly recent change appearing nowhere in the Constitution. Indeed, it is arguably unconstitutional since the only reference to majority in the Constitution is to the Vice-President having the deciding vote on a split vote. Of course, the constitutionality will never be tested due to deference and separation of powers. The real damage done to the parliamentary system over the past few years has been the permanent use of the Filibuster whose use has risen to previously unseen heights. And then,, of course, there was Medicare Part D when the Republicans literally stopped the vote-counting clock for three hours when they realised they had brough a bill to a vote without the numbers. That is something Nancy Pelosi would never do.

the increased cost of health insurance for Americans And here Conservative Cabbie shows himself to be utterly clueless about healthcare in America. My health insurance premiums have doubled over the last three or four years - a rate that far exceeds inflation in both the RPI and healthcare itself. Wellpoint is engaging in price gouging because it can by assuming I would not be able to leave and get insurance from another carrier. I probably could but you know that is only a probably. The healthcare bill addresses that market capture problem by converting that probably into a certainty. This must provide provision will lead to increased competition from insurance carriers - although and regrettable not as much as if they had to compete with any form of public option.

or the longer waiting lists and lack of Doctor's. Twaddle. I spent months trying to find a GP willing to take new patients and ended up with one who would not take insurance because of the hassles. Now, even she has bailed preferring to work in a startup. Many Americans currently have infinitely long waiting lists because they do not have healthcare coverage. But absent healthcare reform the future was just as bleak for many more Americans.

What a strange take on the world you have. CC's take on the world is not so much strange as wrong.

"Lady Gaga". - Interesting ad hominem from a Hollywood liberal. No doubt Madam Botox looks normal to you :-) From what I heard over the weekend it was pretty clear that Lady Gaga basically leads a white power race movement - the teabags are needed to give it some color.

ndm

Conservative Cabbie mocks:

-- And I'd much rather the real world of redneck Oklahoma than the fake plastickey world of Hollywood.

Oklahoma - meth capital of the World.

Vern

As usual with Mr. Massie, it's all about the Republicans. Not Obama's failure to persuade his fellow Democrats, the unpopularity of the bill with the public, Obama's inability to explain the content of the bill, or the way that every time he gave a major speech on the topic, his approval fell, as did the support for the bill. No- it's all about the Republicans- who this time were closer to the mood of the general public than Obama.

Hm. Sounds familiar. This blog is a permanent audition to become Andrew Sullivan's mini-me.

Conservative Cabbie

ndm

Long on talking points, short on facts.

There is no conceivable tax increase I could face that would match the rate increases I have been subjected to by Wellpoint over the years.

Because of the way the subsidies are handled under Obamacare, people on salaries of $30,000 or more face a marginal tax increase of 72% when they move up the income ladder. If you are uninsured, you are now obligated to buy insurance (another effective tax imposition). If you have insurance coverage worth $10,200 or more, you will face an excise tax of 40%. If you are a small business employer, you now face a new payroll tax as well as a mandated requirement to provide insurance (another tax). And on top of that, those insurance hikes will still go on. The CBO estimated that the Senate Bill will result in insurance increases of $2,100 per average family by 2016. I don't know how much your own insurance has gone up but I'd be surprised if it matches those tax hikes on top of the insurance hikes that will happen even when Obamacare becomes law.

Because there is no burden on an employer like a worker who can't come into work because he is off sick and can't afford treatment.

Very true. There are close to 6 million employers in the US. There are eight million people who genuinely can't afford insurance or have access to healthcare. So we are talking one and a third people per employer. But Obamacare imposes new taxes and new layers of bureaucracy on those employers. Caterpillar, the company Obama famousely touted has said that Obamacare will cost the company $100 million in the first year alone.

One of the downsides of the US insurance-based coverage is that those with insurance are isolated to some extent from its cost which has allowed severe inflationary rise in those costs.

And then you support a bill that further isolates them by protecting them with subsidies. On this point I agree with you but it's hardly a case for a government take-over of healthcare, it's an argument for giving people more choice and de-regulating healthcare.

the help that Democrats have given to Insurance company profits with all those extra customers,

If you are fine with increased profits for the health insurance industry, that's fine, just don't demagogue against them. PHRMA and health insurance companies will profit greatly from these reforms. Or at least the big companies will who can cope with increased regulation. It is the smaller companies who will suffer. So these reforms are helping to monopolise the industry and monopolies rarely lead to price decreases.

The Republicans lost all right for a generation to discuss the deficit when it took the Clinton surplus along with a raid on the US Treasury and offered "tax cuts" to the American people.

True. So you are using the "two wrongs do make a right" political argument.Bush's discretionary spending in his final budget for the whole of the federal government was 1.1 trillion. That's 400 billion less than Obama is planning to spend on one program alone (Obamacare's real 10 year number).

the damage done to the parliamentary system This is just plain ignorance.

Obama and the Democrats railed against Bush's signing statements. Pelosi took the GOP to court over deem and pass. Obama and a whole rogues gallery of Democrats took issue with the GOP use of reconciliation, and yet Democrats have used or threatened to use all of those things. It's not me being ignorant NDM. And as for your comment about reconciliation and the constitution, please. The Constitution states that Congress can make it's own rules. Therefore, the filibuster is effectively part of the constitution.

And here Conservative Cabbie shows himself to be utterly clueless about healthcare in America.

And you show that you are clueless about the ramifications of this bill. This bill mandates people to buy insurance or face a penalty (2.5% I believe). Based on the annual average salary, the average penalty will be $1,250. The average annual insurance premium for a single person is $4,824. Obviously it pays to go without insurance and pay the fine especially as Obamacare mandates that insurers cannot deny insurance to those who are ill. In other words, the only people who will be insured are those who are sick. Hardly a recipe for keeping down insurance costs.

or the longer waiting lists and lack of Doctor's. Twaddle.

Not twaddle, an observation from what happened to Obamacare junior in Massachusetts:

"In 2006, Massachusetts implemented mandated health coverage for all residents, insuring hundreds of thousands of previously uninsured patients. Demand for doctors greatly increased, and even though Massachusetts has more physicians per population than any other state, patients are encountering more difficulty in scheduling physician appointments."

From what I heard over the weekend it was pretty clear that Lady Gaga basically leads a white power race movement

That's just stupid in the extreme. Show me some demonstrable evidence that Palin is a racist. You demonstrate your lack of intellectual integrity when you make idiotic statements like that.

ndm

Conservative Cabbie writes:

-- The CBO estimated that the Senate Bill will result in insurance increases of $2,100 per average family by 2016. I don't know how much your own insurance has gone up but I'd be surprised if it matches those tax hikes on top of the insurance hikes that will happen even when Obamacare becomes law. (my emphasis)

This is what Wellpoint wrote to me in January 26 of this year (it would not surprise me if this was not the first mention on the web of the notorious 39% - a thread worth rereading):

-- While we strive to keep costs as low as possible, it is necessary to adjust our rates to cover the escalting costs of health care. As of March 1, 2010, the monthly rate on your PPO Share 5000 will change from $678.00 to $942. (Wellpoint emphasis)

That is a $3168 increase this year alone. Last year the increase was $2040. Two years ago the increase was $792 - equivalent to almost two months payment. Frankly, an increase of $2,100 per average family by 2016 is a fluctuation on the increases Americans already face from companies seemingly more intent on extorting their captive customer base than providing high-quality and cost-effective health care.

Anyone can keep reciting talking points from the most demented wing of a morally and intellectually bankrupt Republican party - but I have little interest in debating their folly.

Conservative Cabbie

ndm

Anyone can keep reciting talking points from the most demented wing of a morally and intellectually bankrupt Republican party - but I have little interest in debating their folly.

The recourse of the liberal. When presented with facts, discontinue the engagement. It is you that is intellectually bankrupt. With every post you resort to insults and yet never engage on the substance. Childish behaviour.

ndm

Conservative Cabbie writes:

-- When presented with facts discontinue the engagement.

Rubbish. I just gave you four paragraphs of facts detailing the insurance bills of one person in America. Inconvenient I'm sure.

The only fact I really care about is that healthcare drains almost 20% of GDP out of the American econonomy. That is a brake on the American economy. My example merely personalizes this economic waste.

Conservative Cabbie

ndm

and I appreciate that view from the coal face. I have no doubt that the system can be improved upon, the question here is whether or not it is worth dividing the country over, whether it is worth increasing taxes for or increasing the deficit.

You accused me trotting out political talking points. Well here is the CBO on the implicit marginal tax increases on middle class families owing to the subsidies within the senate bill:

For example, a proposal might provide families whose income was at the federal poverty level (roughly $23,000 for a family of four in 2013, the year in which many proposals would take effect) with fully subsidized health insurance valued at $15,000. That subsidy might be gradually reduced as income increased, and families whose income was above 400 percent of the poverty level ($92,000) might be ineligible for any subsidy. In that case, marginal tax rates would go up by about 22 percentage points for all families whose income was between 100 percent and 400 percent of the poverty level.

I work in an enviroment where I witness the working poor forego better jobs because they lose welfare. This bill creates this welfare trap.

These are CBO figures.

A family of four in 2016 earning $42,000 will have their healthcare subsidised to the tune of 82% meaning that their insurance costs will be $2,600. If their income jumps to $54,000, the subsidy decreases to 67% and their insurance costs will be $4,800, an increase of $2,200. This is an effective tax only the poor and middle classes will pay - hardly the progressive dream.

No doubt you will argue that they are still better off than the status quo, they are still getting that 67% subsidy. Except, under the status quo, they get to keep all of any increase in revenue and at some stage the status quo will be a post-Obamacare world and in that world, people are being punished to the tune of a quarter of their increased income.

Snowman

ndm:

Have no idea how old you are, hopefully young enough to live to see the end of the insanity of which you’re so proud.

You’re right, the move feels good, compassionate, noble and heart warming. The only tiny problem with it is that it cannot work, it won’t work.

Listen, you cannot run a system whose costs are fixed, yet the demand on its output has virtually no limits. Trust me, I know.

Communism collapsed because it applied the theoretically unarguable rationale (in any society that runs on emotions rather than cold thinking) to the whole of the economy. After a time, the family silver was gone, and the wealth creative part of the economy couldn’t be milked any more. Here in the UK, we have been discovering just that. Since the NHS rules of ‘free at the point of delivery’ only apply to a chunk of the economy the costs can still be pushed higher. Sooner or later, however, a ceiling will be reached, and some serious limitations on who can get what will have to kick in. It has already begun, and will get more pronounced as years go by.

The same will happen with your new system. The really ain’t a free lunch unless you want to bankrupt the whole society. The Chinese challenge to your dominance has just been made a notch easier. Enjoy, whilst the insanity lasts.

ndm

Snowman writes:

-- Have no idea how old you are, hopefully young enough to live to see the end of the insanity of which you’re so proud.

The recently passed healthcare reform bill is the first step in moving the United States away from an insane system which squanders nearly 20% of the country's GDP for seemingly little additional benefit over countries which spend far less.

Snowman then goes on with a stupid linkage in writing:

-- Listen, you cannot run a system whose costs are fixed, yet the demand on its output has virtually no limits. Trust me, I know.

-- Communism collapsed ...

It is utterly imbecilic to associate a bill aiming to end the complete collapse of a market in healthcare and communism. The fact of the matter is that the United States already has significant rationing given teh restricted access to care of the uninsured. A friend of mine was skiing recently and had to visit the clinic in the ski center because his child was injured. He told me he didn't realise how many uninsured there were since over half the injured in the clinic had no insurance and were begging for breaks on the x-ray charges. The story became an even worse indictment of US healthcare when he told me that the clinic sent him to the only local medical center which he discovered was not contracted with his insurance company so he had to pay out of pocket. Of course, everyone has the time to look up a list of covered providers when they are dealing with an injured child.

The fact of the matter is that more rationing is coming to the United States since as a country it can not afford to waste almost 20% of GDP on healthcare - this was one of the problems the US car industry faced over many years and look what it did to them. I think there is little doubt that the US is far closer to the upper limit on what a country can spend on healthcare than is any other competitor nation.

The staff-model HMO, Kaiser Permanente, is often held up as an exemplar of sound delivery of care in the US. Kaiser staff are paid salary and are not paid by procedure. There is therefore absolutely no incentive for them to overtreat as there is in the fee-for-service provision of care. Were the US to move towards a single-payor model the US people would gain much of the benefit provided by Kaiser Permante at a far better price than the current pathetic system is able to.

Anyone who thinks the US healthcare system is really ought to read Atul Gawande's New Yorker article which demonstrates some of the problems.

ChrisX

The behavior of the Repubs in the healthcare date and their position on the healthcare issues are both reprehensive. Perhaps, David Frum realized the lack of a Republican health care choice – but also the limitations and shortcomings (as there are quite a few) within the new health care bill, and though it's aims are laudable, it won't achieve the level of health care reform that could be better accomplished by other means. This is only going to mean we're getting more pay day loans from either the people (via taxes) or foreign banks to give to insurance executives because people have to buy insurance now, and only a lot of people can get subsidized care. UPS and FedEx do better than USPS for a reason.