Peter DeFazio: The Wages of Independence

Steve Novick

Yesterday I was unfair to David Wu. I thought he was wimping out on health care. In fact, he and Kurt Schrader had joined a revolt, spearheaded by [Peter DeFazio](http://www.defazioforcongress.org), of legislators from states that have historically been short-changed by Medicare. The revolt succeeded. Here's DeFazio:

“We’ve negotiated hard and finally have reached agreement today which will give Oregon its rightful share, along with 16 other states who are also being discriminated against under the current formula. This is good news for Oregon seniors and is a critical part of this legislation,” he said.

Why did the revolt succeed? Largely, I think, because Congressional leaders knew that Peter would stick to his guns. When you do things like vote against the stimulus bill because it has too may tax cuts and not enough jobs, it gives you credibility, and therefore leverage.

Now that DeFazio is voting yes, does that make some of you progressives out there feel any better about the bill? DeFazio, of course, did not want to support a bill without a public option any more than you did.

But DeFazio was there is 1994, the last time a Democratic health care bill that wasn't single payer fell apart. And he knows that its failure did not trigger a voter revolt that led to the election of a single-payer Congress. He knows that instead, for 16 years, costs have risen and people have lost coverage.

That's why I think he and the rest of the delegation are doing the right thing. I don't want to lose another 16 years. Because the 'political lesson' that Washington would learn from failure is not that they have to pass single payer; it's that voters don't want a 'big government intervention' in health care.

And consider this: By voting for this bill, Congress will, for the first time, be taking responsibility for the private health insurance system. The flip side of Congress forcing people to buy private insurance is that we can now hold Congress accountable for what the insurance companies do. I think that fact will inevitably lead to increasing Congressional control of insurance rates and practices. I could be wrong, but I think that's a hell of a lot more likely than FAILURE of the bill leading to greater regulation of private health insurance companies.

And of course, I really, really like the fact that the Medicare tax will now apply to unearned income.

Comments

  • Tim McCafferty (unverified)
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    I have the highest regard for the opinion of Steve, and for the most part defer to his opinion as compatible.

    I would though make this point. Rep.Peter DeFazio has fought the truly good fight for progressive issues with not just Republicans, but DINO's abound on the Hill.

    I will stand in support of Rep. DeFazio when the stakes are so high and the Congressman's consistant concern while in the service of the people of the State of Oregon.

  • Details Count (unverified)
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    Steve - To know the full story, since you fancy yourself as the tax geek, of this, we need to know the CBO scoring. A few days ago the CBO scoring was the propaganda message of the day to get "progressives" to bring pressure to bear on those whose opposition was fiscal. That score did not reflect this supposed deal, and so we don't know what it is.

    Moreover, we don't know what revenues offsets to this cost are involved.

    Finally, we don't know if the House members will all have that information before the votes.

    Come on, you're the one with the Ivy League education. These are basic facts, without which the pronouncement of politicians are not to be trusted.

  • Details Count (unverified)
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    And in one more example of progressive fecklessness to pass a bill which is just welfare for the insurance industry:

    DeGette Agrees to Executive Order Making Hyde Permanent on Behalf of Pro-Choice Community

    Now read these two paragraphs carefully:

    According to the Huffington Post, Diana Degette has agreed, on behalf of the pro-choice caucus, to the language of an executive order that the President will issue to address Bart Stupak’s concerns regarding the health care bill. The Washington Post confirms that the executive order would effectively make the Hyde amendment permanent, rather than having to be renewed each year in the Appropriations bill. DeGette says that she would “would support that option, so long as Stupak’s provision is not given another vote.”

    Like I said, you're a Harvard grad defending this bill. Why don't you give us your thoughts on what actually happened here:

    1) The supposed progressive pro-choice caucus drew a line in the sand against Stupak amendment because it makes the Hyde amendment permanent. That Stupak/Hyde amendment is unique because in this supposedly historic legislation because it effectively prevents poor and working women who need federal medical insurance assistance to access medical services from access medical services they and their doctors deem to be medically appropriate. The only such example in the law.

    2) This supposed "progressive" caucus said they would agree to a Presidential executive order making that prohibition permanent, and Obama apparently has agreed to sign it.

    3) They did that solely so they wouldn't have to publicly vote against the Stupak amendment in the bill. And although the Senate bill already pretty much accomplishes the same thing.

    You have an Ivy League education. Why don't you provide us with an serious intellectual and philosophical examination of this, I genuinely want to hear it. (And rest assured, some of us do have the training and knowledge to check the foundations and structure of that discussion, even though we don't have the benefit of Ivy League educations.)

    And while you're at it, why don't you throw in some props for Carla, one of your co-writers who just can't stand it that commenters dare to examine the facts, make arguments based on those facts, and expose people like her who just spout talking points as ignorant. As Webster's assures us they are.

  • Bill Bodden (unverified)
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    "The flip side of Congress forcing people to buy private insurance is that we can now hold Congress accountable for what the insurance companies do."

    Lotsa luck on holding Congress accountable.

    C-Span has archived all the hearings held by Congress. I'm looking for those on health care that Obama promised, especially those he held with Billy Tauzin of Big Pharma infamy. Does anyone have any clues how I might find them?

  • LT (unverified)
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    I admire Peter DeFazio. In the true tradition of Wayne Morse, he fought for what he believed in, even though there were some people taking verbal potshots.

    We are much better off with elected officials like DeFazio than with politicians (who shall remain nameless) who either are poll driven and have no core beliefs, or who let people outside of their own district tell them there is a revealed truth which they are supposed to follow, or else they will be called names, lose funding, etc.

  • Janelle (unverified)
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    Thank you for having the good sense to vote no on health care. I support that decision.

  • Jonathan Radmacher (unverified)
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    While I don't have an Ivy-League education, it doesn't take that to understand that abortion is a pretty unique issue in American politics. Compromises let people keep their "principled" stand, so they can get past it and vote on the issue at hand. Not that I'm opposed to a fight about the Hyde Amendment, but tee it up as that, and don't do it as a tag on that could kill health care reform.

  • Details Count (unverified)
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    Congress will, for the first time, be taking responsibility for the private health insurance system.

    Steve, of course this is not true.

    What Congress is "taking charge of" is creating an administration that will specify the benefits in one type of plan. The plan that a private insurer who wants to participate in the exchange has to offer in the exchange. That plan won't even be available until 2014 and no credible expert is claiming that the expected rate of health care cost will be moderated sufficiently such that the Exchange plan could be a high quality plan and remain affordable. Congress is not taking charge of any other significant aspect of the benefits offered in insurance plans.

    The Congress is also delegating much of the work to the states. Except that the majority of states are already doing what Congress is delegating with regard to implementing a version of the NAIC model for review.

    Finally, the Congress is not taking charge of rate review because, in case you missed it:

    Rate Regs Nixed In House Health Reform Bill

    Steve, as a member of the Bar, you have to feel some duty of candor. So how can you make such superficial arguments that don't square to a first order with the facts?

  • Details Count (unverified)
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    Compromises let people keep their "principled" stand, so they can get past it and vote on the issue at hand.

    Compromises would not appear to be the word you are seeking here. The principled stand DeGette claimed to making was opposition to the Hyde Amendment being made permanent.

    However, the "compromise" she actually settled for was that the Hyde Amendment WAS made permanent just by a different means. She just wanted to not to have to be seen to be voting for it. So your definition of "compromise" would mean the "principled" stand was no more than the appearances of voting, not on the issue itself.

    Maybe the word you're looking for in this case is "Deceits", rather than "Compromises".

  • steve Novick (unverified)
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    Dear Details Count: The rate regulation feature was dropped from the bill because the Senate parliamentarian said that would not fit in the reconcilation process. Obama said he will try again, separately, and I'll be interested to see the Republicans argue against that, as a stand-alone measure. Meanwhile, what I said above was: "The flip side of Congress forcing people to buy private insurance is that we can now hold Congress accountable for what the insurance companies do. I think that fact will inevitably lead to increasing Congressional control of insurance rates and practices. I could be wrong, but I think that's a hell of a lot more likely than FAILURE of the bill leading to greater regulation of private health insurance companies." I did not claim that this bill itself regulated rates, and I acknowledged that I could be wrong. Please explain why you think the failure of this bill is MORE likely to lead to Federal regulation of insurers than its passage will be.

  • Average Joe (unverified)
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    I think everyone needs to remember, the house is voting on the senate bill. End of story. Even with reconciliation it becomes an entirely different deal. Many of the changes requested by congress will not pass the senate because they are not all based on finance.

    If you really want to read some good fiction read the CBO's breakdown and assumptions for the so called reconciliation bill......they are basing numbers (stolen from the student loan program) on net present values of loans that will not be paid back for decades. They also don't take into account the default rate of the loans. It goes on from there. Business does not get away with these kind of justification numbers why should our federal government.

    I believe tomorrow we will start real debate about healthcare change that will help all americans when the bill fails in the house..

  • val (unverified)
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    Nice! Thanks to my Congressman, Peter DeFazio, for having the courage to use this vote as leverage for the best interests of Oregonians and thank you to our entire delegation for fighting this fight for so many years. Great coverage Steve.

  • Johanna Cummings (unverified)
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    I like to think of this as a health insurance regulatory bill, so I'm for it. We still have a ways to go on real healthcare reform.

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    Details count is on a roll. I am really trying hard to not imagine a scenario where millions of American women finally discover that the great leap forward is on the backs of their reproductive choice. Permanent Hyde is really a sad thing to give as a chip--that's pretty desperate. But it's Middle Class white women discovering their plan no longer covers abortion that's gonna bite the Dems.

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    Not to get in the way of the rhetoric, but what exactly is permanent about a presidential executive order? They can be overriden by Congress and rescinded by the President.

  • Stephen Amy (unverified)
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    Does anyone know if Barack Obama, the "Fierce Advocate" (as he's known on the Mike Malloy chat room), is actually pro-choice? Does Obama himself know whether or not he's pro-choice?

    All we know for sure is that Obama will give away just about everything in order to pass a bill which is called "healthcare reform".

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    Great post Steve. You're my favorite tax geek with an Ivy League education. Kudos to DeFazio and company for leveling the Medicare playing field in sixteen states. Back to sulking over Kansas losing their game.

  • Theresa Kohlhoff (unverified)
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    These were good posts which show that people are paying attention to complex issues.

  • Joshua Welch (unverified)
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    this is how to get what you want. could have done the same thing w/ a public option.

  • Kurt Chapman (unverified)
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    Steve, could you please comment on the inclusion of a total revamp of federally backed student loans in this reconciliation? How about the allegation that absolutely no banks other than ONE from North Dakota will be able to issue student loans if this passes?

    The federal student loan guarantee program has lots of issues that need attention. Is cramming it into a bill of this magnitude good politics? Is it good legislative action on behalf of the people?

  • dbc (unverified)
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    Having worked as a civil servant for a couple years and leaving to private industry because I could not stand the undermotivated baeuracracy, I can see what is coming. In the end, Obama will stand or fall on results. My money is on government control of healthcare failing. I've seen that "you want what?" look on goverment workers face too often to believe otherwise. And there will be exactly one side of Congress to thank. In the greatest traditions of the enormous efficiencies of the IRS, Department of Motor Vehicles, Social Security Administration, Veterans Administration, and the bankrupt US Postal Office, I wish you well. I'm sure healthcare will be different. Obama said it will and that's proof. Good luck in the Fall and President Obama, good luck in two years. If it gets screwed up, there will be no-where to hide. No-where. If it is a huge success, I will be the first to say I was wrong. But I doubt it.

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    Thanks for the post. I share your optimism about the future and look forward to the subsequent debates. And, special thanks to Rep. Defazio for getting us closer to Medicare parity. Nice.

  • Bill Bodden (unverified)
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    "Having worked as a civil servant for a couple years and leaving to private industry because I could not stand the undermotivated baeuracracy,..."

    Bureaucracies are bureaucracies whether they are in government or private enterprises. They are subject to the same chances of incompetence and success. The Dilbert cartoon was based on ridiculous bureaucratic practices observed by the author - in a commercial, non-government environment.

  • Bill Bodden (unverified)
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    Juan Cole at the ever informative Informed Comment web site - juancole.com - has an interesting observation:

    " Can US catch up to Iran in Providing Health Care to Least Privileged?

    "Proponents of unregulated capitalism, or if you will, the 'free market,' maintain that it provides a better life for all than do other systems. This allegation is demonstrably untrue if the question is public health across the board. In Iran, under the hyper-capitalist Shah Mohammad Reza Pahlevi, infant mortality was 122 per 1,000 in 1970. Today, in the Islamic Republic of Iran, it is 28.6 per 1,000, an incredible decrease. Some 94% of the population has access to health services, and around the same percentage have access to affordable medicine. The state is authoritarian and controlling, but it cares about the welfare of even the poor among its citizens in a way that the US-backed, capitalist Pahlevis clearly did not. In the last year of George W. Bush's presidency, at a time when he had drastically limited Federal support for stem cell research, Iran committed $2.8 billion to such high-powered medical research."

  • Tim McCafferty (unverified)
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    Without singling anyone out, I would lay a wager in barter that Rep. Peter DeFazio will be on the stage when the Health Care Reform Bill is passed and signed into law.

    Since the start we have had the benefit of a wise, and strong voice of sincere governance. Rep. DeFazio has been the voice calling out the corrupted priorities of Republican control of government. He has been the common sense voice to the most radical of both sides, and pursuasions. Honorable when the time came to call the dogs to War.

    I believe that when push comes to shove, look for me behind Rep. Peter DeFazio on an issue as serious as my family's health.

  • Bill Bodden (unverified)
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    Glenn Greenwall assesses one aspect of this "health care reform" very well:

    "The Washington Post's Ezra Klein has an amazing post in which he trumpets what he calls the "Twilight of the Interest Groups" reflected by likely passage of the health care bill (h/t). Why are Interest Groups -- once so powerful in Washington -- now banished to their "twilight"? Because, says Ezra, "the Obama administration succeeded at neutralizing every single industry." If, by "neutralizing," Ezra means "bribing and accommodating them to such an extreme degree that they ended up affirmatively supporting a bill that lavishes them with massive benefits," then he's absolutely right. He himself notes what he calls the "remarkable level of industry consensus" in support of the bill:"

    The rest of the articles is at Industry Interests are Not in Their "Twilight"

  • (Show?)

    "Veterans Administration"

    If I'm not mistaken, horror stories aside polling indicates those served by VA medical report the highest satisfaction of ANY health care group, including Medicare and all private insurers.

  • LT (unverified)
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    Think about the VA this way: Since the horror stories, the VA has done a quality upgrade (even if underfunded and the people in charge of the VA under GW Bush made mistakes).

    There are veterans who served in 20th century wars who still get excellent care from the VA, even if it is sometimes quite a drive from home. It may take awhile to get an appointment (underfunding has always been an issue) but once into the system, the care is first rate.

  • Tim McCafferty (unverified)
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    Health Savings Accounts! What bunk.

    To say a savings account meant only for your health can be savings is laughable. If you in you twightlight years find your self more than 3 days in hospital, bye-bye savings, interest and all.........

    If you and your wife together makes $75,000.00 combined, then the little you would end up saving in your HSA would not be enough to mend a broken leg. The point of HSA is to put money in bank accounts to shore up bank's balance sheets, as though we haven't done enough of that over the years.....

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    My money is on government control of healthcare failing. I've seen that "you want what?" look on goverment workers face too often to believe otherwise. And there will be exactly one side of Congress to thank. In the greatest traditions of the enormous efficiencies of the IRS, Department of Motor Vehicles, Social Security Administration, Veterans Administration, and the bankrupt US Postal Office, I wish you well. I'm sure healthcare will be different.

    Hey DBC -- what the hell are you talking about? This bill isn't single-payer bill, nor does it contain a public option. (Unfortunately.) There is no "government takeover", there is no new government agency providing health care. Just some regulations and some subsidies.

    The right-wing campaign is pretending that we're talking about single-payer. But we're not. Health care will still be provided by privately-employed doctors and nurses funded by private health insurance. (Not counting the existing Medicare, Medicaid, VA, and public employees health systems.)

  • Tim McCafferty (unverified)
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    Single Payer?

    Let's take the argument that this would be a take over of health care by government.

    If all good buy in to affordable Medicare coverage, or a private policy, then how would that be bad if the private market theory of insurance coverage from for-profit insurance companies if they deliver better and more affordable services?

    Either the private sector is better, or it's not. So, why should they not compete with a Medicare program that has only 3% administration costs for comprehensive coverage opposed the the 30% of premiums that costs to administrate the private policies?

    A question that seems of base for the other side.

  • Bill Bodden (unverified)
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    The health care system (?) that functions (?) currently in the United States is a market-based system and it is the worst overall system in the developed industrial world. So, why should we continue with it? Others with varying degrees of government components - Switzerland, France, Germany, the U.K., Italy, Japan, Taiwan, etc. - have much better systems where their citizens don't have to worry about going bankrupt because of medical treatment or dying because they can't afford medical services that could save their lives. The United States can claim to have some of the best doctors and hospitals in the world, but if people can't afford to pay for their services, what good are they?

  • Details Count (unverified)
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    Please explain why you think the failure of this bill is MORE likely to lead to Federal regulation of insurers than its passage will be.

    Just so you know Steve, if you see this, Blue Oregon is apparently blocking IP addresses according to some criteria that may or may not be content related. Visited a different place to post this. There were three responses composed to your point, if you really want to read them and share them, look at your blog server.

  • Bill Bodden (unverified)
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    "Blue Oregon is apparently blocking IP addresses..."

    I suspected this might have been the reason some of my postings disappeared a few days ago, but Kari assured me that wasn't the case. The probable cause apparently was an erroneous suspicion by the server that my posting were span. While Kari and I have been on opposite sides of some threads I don't question his integrity in running this site.

  • Details Count (unverified)
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    The probable cause apparently was an erroneous suspicion by the server that my posting were span.

    Yes and no. Commercial blog software these days has reasonably sophisticated, but configurable, spam filters. So the server probably did think your/my posting was spam. There's only one way to know why, and that's something only someone affiliated with Blue Oregon can explain.

  • Bill Blank (unverified)
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    It was announced that 11 Republican State Attorney Generals were going to challenge the Health Care Plan passed by Congress on constitutional grounds. This is classic republican strategy. First they gave us George W. Bush, and now want the Supreme Court to ultimately reverse what Congress passed. If this comes to pass, contrary to what conservatives think, the public will revolt by expressing their outrage at the polls.

  • dave edwards (unverified)
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    I hope all four of our Representatives rot in @#$# for voting in a new 3.8% tax, and for raising medicare taxes by 1/2% and removing everyone's Pro Choice if they want medical insurance or not. Some of us have the means to pay for our medical bills directly!

    Don't expect to get re-elected!

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    "The executive order is a "permanent" enactment of the Hyde Amendment"?!?

    Please!

    Liberals at least should be informed on basic civics. By the executive order--stating nothing more than the status quo and subject to repeal at any time by a Congress with spine or the president, like next month (!), Obama and the Ds walked the anti-abortion Ds back off the limb, including stellar liberals, like David Obey and Jim Oberstar.

    Can't liberals grasp a coup when it's in front of their nose?

    Lest anyone think that the Hyde Amendment cannot be defeated, let me remind you that I led the successful House fight to do just that in the late 80s. The pro-choice forces didn't carry the day in the Senate then, but whom do you suppose was responsible for that if not ourselves?

    Beyond the issue at hand, my point is that liberals need to have an advanced understanding of civics or they are doomed.

    Congressman Les AuCoin (ret.) D-OR, 1st District The Les AuCoin Blog

  • Kurt Hagadakis (unverified)
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    While Kari and I have been on opposite sides of some threads I don't question his integrity in running this site.

    I have had to reluctantly conclude that that assumption is not always valid, as he doesn't always know what his little helpers get up to.

  • LT (unverified)
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    Thank you for the civics less, Les.

    And before people get too hyper, there is a difference between making abortion illegal to get a bill passed (this didn't do that) and just doing something about how it is paid for.

    Liked this:

    "Obama and the Ds walked the anti-abortion Ds back off the limb, including stellar liberals, like David Obey and Jim Oberstar."

    My guess is that lots of women like me who have admired Obey over the years were stunned when he joined the Stupak crowd.

    Obama showed himself to be a skilled negotiator---a much needed and underappreciated skill.

  • LT (unverified)
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    "civics less, Les"

    Proofreading error! Obviously I meant civics lesson!

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