Single-Payer

Posted on 08/27/2009 at 8:16 am by Bob Cesca

In the comments under my Huffington Post column there are quite a few “single-payer now!” remarks.

While I support single-payer in theory, here’s my big question. Can anyone present a realistic path for single-payer to pass and become law? I’m talking about where the votes would come from for a three-pronged reform bill that 1) dissolves all private health insurance corporations and HMOs, 2) replaces them by either setting up a new government health insurance system or expanding Medicare for everyone with compulsory participation, and 3) reconfigures Medicare coverage to eliminate the need for supplemental private insurance.

If someone can tell me realistically where the support and votes will come from, I will join the ranks of “single-payer now.”

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  • Eric

    *crickets*You could have the entire Senate filled with Democrats and I wouldn’t bet on passage of single payer.

  • http://www.limnerslines.blogspot.com CMiner

    You’re going to need to keep the supplemental insurance market to win enough votes. But if the health insurers, like the auto companies, are forced to retool, they could actually create new products that require a lot less administration. And, they’d be much more profitable.I used to work for a small-medium multiline insurer that sold health insurance. But they were losing money on it, so they dumped their health products. Instead, they created new coverages that were less work to administer. So it can be done.Change — any change — is the obstacle here, not what is really possible. Health insurers would take a short term hit to retool, but in the long term they’d make more money. And it would help stabilize our entire economy by allowing American companies to compete globally and new businesses to start.Universal health care would be a huge economic stimulus. But do you every see anyone make that argument?

  • http://www.osborneink.com Matt Osborne

    You can evolve toward single-payer, but the infrastructure for it doesn’t exist right now. You’d basically have to nationalize the insurance companies and there’s a world of trouble involved, not least of which is that the Supreme Court would inevitably be involved.

  • J

    @CMiner: So true re: economic stimulus. But you may have noticed that a whole lot of Congress opposed economic stimulus. The bottom line is to get single-payer–to get any sort of reform–someone’s going to have to lose money. In the case of single-payer, a lot of someones. And a lot of jobs. And people want change as long as it doesn’t affect them one bit. And that’s just not possible.

  • chauncey

    Matt,the infrastructure for a single-payer system already exists with both Medicare and the VA. As has been suggested by others much more educated on the subject, we start by lowering the age when Medicare kicks in to 55, then go progressively lower as reforms are made to the current Medicare system and we are able to absorb the additional costs.Also, Bob, single-payer does not require the complete dismantling of the health insurance industry, there will always be a market, as is currently the case in Canada et al., for supplemental insurance as well as high-end insurance products for those willing to pay for them. As with UPS and FedEx, a healthy private industry can exist, and yes, even compete with a government run system. No one has to go out of business, unless their business model is not flexible enough to change with the changing markets.

  • chauncey

    Sorry, Matt, my post should have read “….much more educated on the subject than I am”.I did not mean to imply you were uneducated about the issue. Need. More. Coffee.

  • Hielo

    There is only one path to single payer. Over time, the Public Option works very well. A system of supplemental insurance evolves. A mass migration from the health deniers occurs. The conventional system becomes a dinosaur and sinks into the mud.This, of course, will take decades. Nonetheless, the insurance ceo’s are losing sleep over the concept. The Public Option is a “trojan horse”. Hopefully, these so very competent managers will up their salaries sufficiently to hedge this possibility. A half-billion dollars should do it. Capitalism, you know.

  • http://www.bobcesca.com Bob_Cesca

    chauncey wrote:

    Also, Bob, single-payer does not require the complete dismantling of the health insurance industry, there will always be a market, as is currently the case in Canada et al., for supplemental insurance as well as high-end insurance products for those willing to pay for them.

    Point taken, but even then we’re talking about an almost complete government retooling of the private health insurance corporations. We’re talking about a reduction of business down to a small elite niche from a massive part of America’s economic infrastructure.Regardless, where are the votes for such a thing? How would the strategy for this play out and how would it be received by Congress and, more importantly, the ridiculous corporate press?(Again, I want to emphasize that I’m not opposed to single-payer.)

  • cynicalgirl

    Single payer would never pass today; however, if the debate had started out as “single payer” and the compromise was “public option”, we’d be in a much better position today.

  • Allonfla

    I don’t understand why anyone is still shouting single-payer NOW! when we can’t even get some of the Dems to vote for the public option.

  • http://www.pnhp.org/facts/single_payer_system_cost.php Terri

    I don’t think the “moral imperative” argument works here: if that were the case it would have worked long ago. It’s futile.The real reason SINGLE PAYER should be a go now is because of it’s ECONOMIC BENEFIT and COST SAVINGShttp://www.pnhp.org/facts/single_payer_system_cost.phpIt should be sold, during this economic crisis, as COST SAVING and SMART ECONOMIC SENSE.It can still be gradual, but it must be single payer — perhaps something akin to lowering the age of medicare recipients over time (keep dropping the qualifying age.)And, here’s a beautiful Q & A on single payer:http://www.pnhp.org/facts/singlepayer_faq.phpWe've been talking about health reform for 40 years — this is ridiculous! It’s time to really knuckle down and some some REAL reform.Bob, I for one, would be very happy if you would research single payer more and blog here and write for Huff Post in SUPPORT OF SINGLE PAYER.It’s the right solution for these times.

  • http://www.pnhp.org/facts/single_payer_system_cost.php Terri

    I reject the “Single Payer Would Never Pass” notion……

  • Woody

    The first prong (dissolving private insurance and HMO’s) presents the biggest obstacle. The response will be that reformers are against business (inflaming the trickle-down crowd), against workers that will lose their jobs (inflaming people that seemingly dislike their premiums being used more effeciently), and against capitalism (inflaming people that are willing to put their health on the line to save the right to make a profit).What I don’t understand is how removing a 20 – 30% burden from the backs of corporations and small businesses that currently provide health insurance is a bad thing. I would think this would be good for the trickle-down people, and would result in more jobs and industry competition. I also don’t understand how our industry is expected to compete on a global market against corporations from other countries that don’t have this burden.

  • bjritz

    I’m with Hielo on this.The public option would need to be offered to all, not just those who don’t have health insurance now. It would need to provide care comparable to current private plans at a lower monthly charge and with lower co-pays. Then some people would choose it and if it plays out as well as Medicare, then word of mouth would spread the like-ability of if it. More people would begin to use it, I think it would be a slow process, but would gain momentum. The insurance companies would then adapt.The right would find every possible problem and promote the difficulties. The people who are happy with it would countermand this with low key praise for the new system, which would spread and gain momentum year by year.The best thing a strong public option set into law would do is show the insurance and pharmaceutical companies that they have just pissed away millions in profits for what people don’t really want. They too can be trained through capitalism and choice.

  • http://www.pnhp.org/facts/single_payer_system_cost.php Terri

    I don’t know where my other post went!But, here are some Single Payer FAQ’s, please read:http://www.pnhp.org/facts/singlepayer_faq.phpThe biggest argument in favor of Single Payer is cost-savings!SINGLE PAYER MAKES ECONOMIC SENSE — which is very right for the time.I don’t think the “moral imperative” argument will work: if it worked, we would have already have had it..as this debate has been going on for 40+ years.The angle needs to be COST SAVINGS, as in this link (How Much Would Single Payer Cost?):http://www.pnhp.org/facts/single_payer_system_cost.phpThese economic times demand a health solution which makes ECONOMIC SENSE — as Single Payer does.Please check out the links, above, and these:http://www.democracynow.org/2009/6/9/sen_bernie_sanders_and_nurses_unionhttp://www.healthcare-now.org/dems-have-super-majority-to-demand-single-payer-universal-health-care/Also, follow Bernie Sanders and his arguments!Gotta run..

  • chauncey

    “Point taken, but even then we’re talking about an almost complete government retooling of the private health insurance corporations. We’re talking about a reduction of business down to a small elite niche from a massive part of America’s economic infrastructure.” (sorry, I haven’t quite got the hang of cutting and pasting quotes properly)It would not necessarily require the government to retool the corporations. Market forces would provide the impetus for it to retool itself. It’s no different than any other industry where companies find themselve needing to market “new and improved” products to stay competitive. That’s exactly what the Public Option is designed to do right now, infuse the industry with a healthy does of competition resulting in, theoretically anyway, a more efficient, less bloated private industry.And as far as a reduction in business is concerned, a greatly (and gradually) expanded Medicare system would require the hiring of thousands of experienced health insurance industry professionals to handle the increased load as folks are slowly moved into the system. Think of it as similar to retraining our manufacturing workforce for alternative energy jobs.Now as far as marketing the single-payer/ Medicare for all concept, you’ve got me there Bob. But I honestly think it would be much easier (and simpler) for folks to wrap their minds around expanding an existing program, than to start a new scary “gummint” program from scratch.

  • http://www.pnhp.org/facts/single_payer_system_cost.php Terri

    Bob,I have encouraged others to join this thread. They are new to your blog and are having difficulty signing in and participating.Can you offer some assistance please?Thanks,Terri

  • iLLogicaL

    Single payer is the stance we should have started with. You don’t go in to a car dealership and straight away offer the maximum you can afford to pay.

  • http://www.bobcesca.com Bob_Cesca

    @Terri. I noticed. You have no fewer than three posts about it on your Facebook page.

    I reject the “Single Payer Would Never Pass” notion……

    Then tell me how it would pass. That’s the point of this post, Terri. Where are the votes? Where’s the financial support for the massive PR campaign it would require? Wishing for single-payer won’t make it so. It needs votes. So tell me. That’s what I’m asking here.

  • http://www.bobcesca.com Bob_Cesca

    Terri:

    They are new to your blog and are having difficulty signing in and participating.

    After they register, they need to clear their cache before signing in. Or they could just hold down the Shift key while they click Refresh on their browser.Beyond that, I need to stick with registration for now. Too much spam/trolling without it.

  • http://nanotyrnns.blogspot.com/ Nanotyrannus

    Maybe the whole thing should be done quietly. No fanfare. Keep lowering the eligible age for Medicare by ten or 20 years every year. Make it available, but don’t make it mandatory. Eventually enough people would be buying into it and abandoning private insurance to the point where the private insurance industry either get out of the business altogether or tighten up and compete.Just talking out of my ass on that one.

  • Hielo

    @ ILLogicalStarting with single payer may have been a reasonable bargaining tool.But, in light of what Bob says (100% correct), would it have seriously lessened Obama’s credibility?

  • DaBomb

    @Bob- That has been my complaint about the single payer now too. How can it be done without completely overhauling the entire medical industry.I read Booman’s blog yesterday and there was a post about this same exact thing. Someone mentioned that there hasn’t been alot of work done by the single payer advocates to promote it or inform the public about how it would work within the present framework of our system.People just say they want single payer but can’t explain how to implement it.I am for single payer myself in theory and I think the public option will eventually get us down that road.

  • Eric

    Rep. Weiner is one of the most articulate proponents of single-payer that I’ve heard, lately, aside from Bernie Sanders, and he apparently doesn’t think it’s practically achievable today.His suggestion seemed to be similar to what Nano said a few comments up. Expand Medicare, 10 years down at a time.

  • http://www.pnhp.org/facts/single_payer_system_cost.php Terri

    Thank you, I will pass it along. I appreciate your responsiveness and your willingness too to explore further and find a path toward significant reform.Keep up the good work!Terri

  • http://nanotyrnns.blogspot.com/ Nanotyrannus

    That’s probably where I picked it up, Eric. I love me the Weiner (that one was for you Redmond). And add to that the idea of just doing it quietly while saying “Hey, this would be for people that private insurance doesn’t currently insure for various reasons, and anyone else that wants to participate.”What would be awesome would be the looks on the faces of the low authoritarian followers when the industry they spent so much time championing and cheerleading for suddenly abandons them altogether in favor of more profitable endeavors.

  • Hielo

    @ EricDropping the age for Medicare may not be highly regarded by younger people that need help now. The Public Option would. I think.

  • http://arkytek.blogspot.com/ SillyGit

    This is from Kevin Zeese on facebook. I agree with this in its entirety. He says this much better than I.-Git———–I could not figure out how to log in to Bob’s blog page, but glad to see him asking about whether single payer can pass the political test.One thing that the health care reform effort has shown is that a multi-payer system cannot work, i.e. it cannot cover everyone nor can it control costs. The House and Senate, with five committees working on it, have tried all sorts of ways and they just cannot fit that round peg into the square hole.How do we get to single payer? We are not going to get there this year. The year was wasted on the dying multi-payer, employment based health insurance system. We are losing more people to insurance-less life than we are gaining. The hole is getting deeper. And, with the economy in downturn we need single payer more than ever. It will create two million new jobs, hundreds of billions in new economic activity and ensure that the recovery creates jobs in small and large businesses. The multi-payer approaches being discussed will be an anchor on the economy and ensure a jobless recovery.Second, we are not starting from zero. There are 85 co-sponsors to the leading single payer bill. That is not a bad base to begin with.Third, we need a lot more public education. Obama understands single payer and has said some good things, e.g. only single payer covers all, single payer controls costs, single payer is not socialism. His leadership is critical. Will he stand up to his donors from the health profiteer industries? If he does it will save his presidency which is moving in the direction of a one-term presidency.Obama needs to acknowledge that the multi-payer system was given a chance and it just does not solve our problems. And, we have to solve them. The country is going bankrupt over health care — Obama knows that. He needs to keep making that case — explain how this is not socialism, how people will have more choice of doctors, hospitals and treatments and will be able to change jobs more easily. How this will make U.S. business competitive in the world and how single payer will increase jobs because employers will not fear the uncontrollable cost of health care. All the arguments favor single payer.Obama also needs to acknowledge the single payer movement which has shown itself to be well organized and pushing the issue. He has felt the pressure himself when he had his first White House summit on health care. He excluded single payer advocates but was forced to include us after a lot of pressure. If Obama had acknowledged the outcry from the single payer movement and showed he was listening the movement would have multiplied dramatically.If Obama switches the ranks of supporters of single payer will explode. Most of the non-profits working for his health plan are really single payer supporters but they do not want to offend Obama. And, there are many more in Congress — including key people like Waxman and Miller — committee chairs — who are with us. His base is not energized about the current health care bill because is it a multi-trillion dollar annual giveaway to the insurance industry. We are all turned off by it so not pushing for it. I think we’d be better off if it failed. The insurance industry is already corrupting American politics, why give them more money to do so?Obama needs to make the case and make this the 2010 election year issue. Rather than losing seats the Dems will gain them.This is a three year effort so do not be fooled by the head count now. Every major paradigm shift in history — ending slavery, union rights, social security, medicare, medicaid, women voting, ending child labor, civil rights for blacks, gays getting married — all looked unwinable but became inevitable. Obama will go down in history as one of our greatest presidents if he does this. If he doesn’t he will be what he has been so far — a corporate-Wall Street Democrat who puts his donors first.In the end, single payer will be inevitable. It is the only way to solve the health crisis in America.Obama needs to get on the right side of history.KZ——————–

  • FrictionSoul

    But Bob, isn’t this “where would the votes come from” deafeatist in itself? It basically says Congress represents Them The Corporations and not we the people, no?@ JWhy would someone losing money be a bad thing? I don’t think they would lose money at all; they would be forced to be competitive.@chaunceyYou’re ignoring that the government sets the parameters for the market, any market. Businesses do not operate within the same scope and parameters all over the world.Health care is where it today thanks to government, namely Pres. Nixon.

  • Eric

    This is a simplistic scenario (but…all I’ve got is a simplistic mindset, at this point, when it comes to reform) but it seems that if you get a public option in place, and if the health care price curve is currently what it is, then market forces would guarantee that in (5 years? 10 years?) you would have, for all intents and purposes, a single payer system. Or at least in 5 years the PO ranks would have swelled to the point that the general good would be, obviously, served by switching over to a single payer system and there wouldn’t be the resistance to that like we’re experiencing today.I know I’m most likely missing a whole lot in what I wrote but…

  • Hielo

    Hello Git!Regarding the KZ blog……So we give up on the Public Option and we suffer a major defeat? In several more years we can win?Look, we all want single payer but I think KZ needs to go big picture here. He has forgotten about the bribery and douchebaggery issues that are dominating so many of our elected dickheads. Also, that the Repugs don’t care about health care. A defeat for Obama is all that motivates them. Why hand it to them now?

  • Hielo

    @ Eric againYou got it. I wish we could all agree on this scenario and get the PO done.

  • http://www.bobcesca.com Bob_Cesca

    Git wrote:

    This is from Kevin Zeese on facebook. I agree with this in its entirety. He says this much better than I.

    Zeese is basically saying we need to wait.We can’t wait.A bird in the hand, and yada yada. How many deaths every two months from a lack of health insurance? The same as were killed on 9/11. Every 60 days. Two-thirds of all bankruptcies are healthcare related — a majority of those are by people who HAVE healthcare. You know all the stats.Foregoing reform and a public option now for the sake of something — maybe — three years from now is a gamble I’m not willing to take. Since, you know, I’m uninsured.Zeese also wrote that it’s “unlikely” the public option will pass. Well if we can’t get the public option to pass, how in hell do we expect single-payer to pass.And finally, NONE OF YOU need to convince me on the merits of single-payer. I’m for it! Understand me? I support a government single-payer health insurance system. I just don’t think there’s a snowball’s chance in hell it would pass anytime soon.So here’s my answer to my own question.How do we pass single-payer? Where are the votes?We practically have the votes now for the public option which will serve as a gateway to a government single-payer insurance system. Let’s pass that along with other cost cutting measures while insuring as many people as possible.While this stop-gap is in place, everyone who wants single-payer ought to be channeling their mobilization efforts into solid campaign and lobby reform. Publicly funded elections, eliminating lobbyist contributions, and a lengthy non-compete for government officials who try to make the slimy move to K Street.Then the way is paved for single-payer. There’s the path.It’ll take some time, but based on the view of Zeese and others, waiting doesn’t appear to be an issue.

  • http://arkytek.blogspot.com/ SillyGit

    Never negotiate with the crooks that are robbing you. Kick them in the nuts instead.The people running the Health Care Reform campaign are either incompetents that failed Negotiation 101, or there has been closed door negotiations that we are not privy too.When you negotiate, you always ask for more than you know you can get so that you can fall back to a position you are willing to settle for.We should have been demanding Single Payer. DEMANDED IT. ALL ALONG.Then we could have negotiated and fallen back to public option, which will not solve our problems but is a step in the right direction.INSTEAD WE GAVE UP OUR BIGGEST POKER CHIP FOR NOTHING IN RETURN.This campaign has been a clusterfuck from day one.I said this back in may when I predicted that because we were not demanding Single Payer, we may find it impossible to get the public option.If we don’t get at least the public option then this was just a huge waste of effort. We had the best chance of getting single payer that I have seen in my entire lifetime. I think we just blew it. I’ve been watching this in horror as liberals eat their own and fail to embrace a strategy that could win.I no longer have any hope what so ever of any meaningful health care reform being enacted. I look forward to being gouged for my insulin for the rest of my life unless I move to another country. Any other country.The sad truth is that the people leading this campaign sold us out to the insurance cartel. Obama traded away Single Payer to get the corporate overlord’s support for his presidency. Single Payer was quietly drowned in a bathtub last summer. That’s why it was taken off the table.

  • http://www.bobcesca.com Bob_Cesca

    Friction wrote:

    But Bob, isn’t this “where would the votes come from” deafeatist in itself?

    Sheesh. NO! It’s practicality.

  • http://www.bobcesca.com Bob_Cesca

    Git wrote:

    We should have been demanding Single Payer. DEMANDED IT. ALL ALONG.

    Yeah, yeah, yeah. I get it. But you’re still not answering my question.I hear lots of whining, yelling and complaining. No practical solutions.

  • Eric

    Git, I’m with Bob here. I agree with almost everything in your last comment but…without a time machine, what good does it do us?

  • Hielo

    Lee! Lee! Where are you?We are getting back to our smart and practical president is “selling us out”. You know, the “I want things to go my way. Even if it’s impossible” rant.

  • torque

    Way to start this? With SCHIP.Extend health benefits to all children.Everyone now under 18 will have single payer for the rest of thier life unless they opt out.

  • chauncey

    Bob, I’m one of the working uninsured myself -actually I work for the largest national non-profit system in the country, yet because each office is locally operated very few members of the system provide their employees with health insurance….anyway, I digress.I understand what you are asking but I think you are asking us the wrong question. You wanted to know how we get the “votes” for single-payer, when the question really should be “how do we ultimately get to a single payer system?”While yes, singlepayer is not only the morally correct path but also the most economically sound path to follow, it is unlikely to happen overnight in one fell legislative swoop.Few people understand that Medicare evolved from a weak and very limited program when it was initially passed. The reality of the situation is that true health care reform, which I believe will ultimately result in a national health service, will evolve also.And I agree with you completely, once we pass the public option we need to keep the pressure on to move towards a single payer system. But for now, our energies are best spent on supporting the next best thing – the public option.

  • Terri

    Hi Bob,To move the discussion toward the practical, can you please state the following:1. You analysis about why passage won’t work.2. What would actually need to occur for passage?I will look forward to your reply.Terri

  • http://arkytek.blogspot.com/ SillyGit

    I fight for what I know is right. Most people do. When reality rears it’s ugly head and forces me to compromise, THEN AND ONLY THEN I compromise.We gave up single payer voluntarily without a fight. That was a very stupid and ill advised thing to do.Because of that, we lost the support of many advocates.A poll in late April or early May showed that 77% of Americans supported a single payer medicare for everyone type health care system.If 77% of the voters is inadequate to get more than half of congress to vote in favor of what the 77% want, then who is congress representing?If they are not representing the voters, then we can expect more of what we have been consistently getting, fucked.

  • Terri

    I just don’t thing “public support” is enough.”Everyone wanting it” is not enough.Bob is asking the right question: how do we practically get it done.What needs to occur? What’s the plan?

  • http://arkytek.blogspot.com/ SillyGit

    We get the votes by using twice as much money as the insurance cartel to bribe congress for their vote. That seems to be how it works now.-GitAnother comment by Kevin Zeese———–The comments made fear Obama suffering a defeat. He needs to handle this right in order to turn defeat into victory. First, scale down the goals this year. Instead of a trillion dollar plus annual giveaway to the insurance industry just regulate the industry, e.g. pass the provisions on requiring coverage for pre-existing illness, cut the funds for Medicare Advantage which is a disaster to Medicare. Then, explain how the effort this year demonstrated that the multi-payer system cannot work — it cannot cover all and cannot control costs. Go back to his roots on this — the pre-U.S. Senate Obama who supported single payer when the Dems won back the House, Senate and Presidency. Then, make health care for all, reducing the cost of health care, saving American business massive health care dollars and creating new jobs through single payer the election issue of 2010. It will be a reason to get rid of more Republicans and pressure the centrists and Blue Dogs.This will save Obama’s presidency.The current bills will not only fail to solve the health care crisis — they will make it worse by empowering the insurance industry that is the cause of the mess. They need to lose power, not gain it. The insurance industry is hated by Americans.If Obama leads on this the health care reform movement will be with him. Many in his base are sitting this fight out because it is an insurance giveaway disguised as health reform. It transfers wealth from workers to the corporate profiteers. Many of the organizations working with Obama really prefer single payer. The movement will explode and Obama and the Dems will ride the wave to success.If Obama stays on this course, it will be a disaster for the Dems because it is a false promise that will be visable by 2010 election day.Obama needs to get on the right side of history. Single payer is inevitable. It is the only way to solve the health care crisis.KZ

  • http://www.afterdowningstreet.org/node/44566 Terri

    Hmmm…..some buzz (connected with Kucinich) to permit individual states to provide Single PayerOn 7/17:House Committee Allows States to Create Single-Payer Healthcare”….will not alter the federal legislation except to allow states to create single-payer healthcare systems if they choose to. If this change to the bill makes news, it will pass the Senate, because there is no legitimate argument against it, and the support for it is bipartisan.”http://www.afterdowningstreet.org/node/44566ROLL CALL ON VOTE TO ALLOW STATES TO CREATE SINGLE-PAYER HEALTHCARE9:40 a.m. ET, July 17, 2009House Committee on Education and LaborY=Allow states to provide their citizens healthcare if they chooseN=Ban statesPASS= Pass–= Not present or no response25 to 19 to 2Democrats* George Miller, Chairman (CA-07) N* Dale E. Kildee (MI-05) N* Donald M. Payne (NJ-10) PASS, Y* Robert E. Andrews (NJ-01) N* Robert C. Scott (VA-03) –, Y* Lynn C. Woolsey (CA-06) Y* Rubén Hinojosa (TX-15) N* Carolyn McCarthy (NY-04) N* John F. Tierney (MA-06) –, –, Y* Dennis J. Kucinich (OH-10) Y* David Wu (OR-01) PASS, PASS* Rush D. Holt (NJ-12) Y* Susan A. Davis (CA-53) PASS, N* Raúl M. Grijalva (AZ-07) Y* Timothy H. Bishop (NY-01) N* Joe Sestak (PA-07) N* Dave Loebsack (IA-02) Y* Mazie Hirono (HI-02) PASS, N* Jason Altmire (PA-04) N* Phil Hare (IL-17) N* Yvette Clarke (NY-11) –, –* Joe Courtney (CT-02) N* Carol Shea-Porter (NH-01) –, Y* Marcia Fudge (OH-11) Y* Jared Polis (CO-2) PASS, Y* Paul Tonko (NY-21) –, –, Y* Pedro Pierluisi (PR) –, –* Gregorio Kilili Camacho Sablan (Northern Mariana Islands) N* Dina Titus (NV-3) N* Judy Chu PASS, PASS,Republicans* John Kline, Ranking Member (MN-02) Y* Thomas E. Petri (WI-06) Y* Howard “Buck” McKeon (CA-25) Y* Peter Hoekstra (MI-02) PASS, Y* Michael N. Castle (DE-At Large) PASS, Y* Mark E. Souder (IN-03) Y* Vernon J. Ehlers (MI-03) Y* Judy Biggert (IL-13) Y* Todd Russell Platts (PA-19) Y* Joe Wilson (SC-02) Y* Cathy McMorris Rodgers (WA-05) Y* Tom Price (GA-06) Y* Rob Bishop (UT-01) –, –* Brett Guthrie (KY-2) Y* Bill Cassidy (LA-6) PASS, N* Tom McClintock (CA-4) N* Duncan D. Hunter (CA-52) N* Phil Roe (TN-1) N* Glenn “GT” Thompson (PA-05) NUPDATE: final vote tally was 27, 19, 2. We picked up Wu (who switched his pass vote) and Clarke (who showed up late but has been consistent in her support).

  • chauncey

    @ TerriUnfortunately, this state single payer option is just a co-op plan in sheep’s clothing – which is why you see some bipartisan support for it. The main problem with the state level co-op plans is that they lack the negotiating power to truly effect health care costs. They therefore provide no real competition to the private insurance industry unlike a federal public option.It’s a bone, nothing more.

  • davegreen

    If Govt. run, Medicare/medicaid is made availible to everyone;A person can pay into this pool throughout one’s working life. This would increase the total pool of money going into the system.The Govt. run Medicare/Medicaid system is much more efficient . A higher percent of the money which is payed in, goes directly to patient care, rather than to administrative costs[ie, executive saleries]A single payer Govt. run system would offer health services regardless of where I work. If I get sick and can’t work, I would still be covered.As a self employed person, I would have the ability to receive medical services.If it’s a federal healthcare system, I could get treatment regardless of which state I need health services.Much of the fraud would be eliminated, because everyone would be covered, therefore, people wouldn’t have to come up with a scam to receive health .services

  • MrBrink

    Bob, you know what I love about you? You’re trying to be the voice of compromise over what it is that’s on the table right now, not some could have-should have proposal. You’re dealing with the here and now.But this thread is a great start and I’d like to simply re-visit Ted Kennedy’s S.1218:2007-2008 Medicare for All ActIt would be administered and implemented like Social Security.And this is just an observation nobody seems to want to point out– There is a great number of Democrats and Republicans that disagree with HR 3200. Who says we all can’t come to agreement sometimes? Sure, the motives are vastly different, but Social Security is something that reaches all people to a great extent.We could begin referring to Medicare for all as we do Social Security. A staple and a necessary safety net not subject to the whims of free market enterprise where life and death with dignity is regarded as American values.Thanks for all you do, Bob.

  • MrBrink

    I’d like to direct you to barath at the Kos who says, “The bill was amazing in its simplicity.”It’s a simple, viable case in favor, if that’s part of what you’re looking for.You were absolutely on to something when you used your respected platform to simple state, “If we’re gonna name it after Teddy The Lion, it better not suck.” To paraphrase.Well, let’s do what Teddy would have wanted and offered, or remind the powers that be we have already sacrificed too much to save their sorry asses, and we’re not going to accept any more can-kicking solutions that enrich insurance corporations to the detriment of tangible reform.

  • DLF

    I have “elitist, niche supplemental insurance” here in Canada. So elitist & niche that pretty much everyone who has a job in a company of over 20-25 people have it, and every university student in BC has access to it. I’m actually a dependent on my husband’s policy at Simon Fraser University, where he is a student.So. F’n. Elitist. My socialist ass can barely live with myself.

  • Hielo

    O.K.GitI am getting a headache reading your comments followed by this guy Kevin Zeese. Who is this guy anyway? A true FAE with a specialty in health care?You say…..”I fight for what I know is right. Most people do. When reality rears it’s ugly head and forces me to compromise, THEN AND ONLY THEN I compromise.”KZ says to compromise now and pass a very limited bill that will just prove that the current system sucks. That way, Obama can come back later and say all the things he is saying now but by then it will all be different. WTF?You say….”We get the votes by using twice as much money as the insurance cartel to bribe congress for their vote. That seems to be how it works now.”Well, you certainly get it. You know the problem. You also know that there is no way the consumers can play the bribery game. What is it that Zeese doesn’t get about corruption?Cocktails!

  • http://www.afterdowningstreet.org/node/44566 Terri