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Is Health Care Reform Just Paper on the Bird Cage Floor?

It depends on who you ask, but Press Secretary Robert Gibbs said Sunday that health reform legislation is “still on the one yard line.” Other prominent Democrats, such as Evan Bayh and Howard Dean, suggest that we dump that House turkey and start all over again.

Who’s right?

Last August I predicted that health care reform was unlikely to materialize in the near future because that little window of factors that had to line up was not open wide enough.

Let’s revisit and update (my comments in italics):

1. The political landscape needs to be dominated by one party (i.e. who controls decision-making, primarily Congress and the Executive Branch). Obama should have this one on his side, but some donkeys are restless, perhaps because the public does not seem to like what has been put out so far, and members of Congress want to keep their jobs after this election cycle.

2. The President has the ability to pull people together (“a uniter”). He still has lots of friends, but poll numbers continue to slip. The “magic” is wearing off for many previous supporters and those who did not think he was ready to be President are learning how right they were.

3. The people are willing to give government a chance to do something right and competently. Awful timing. People are now watching helplessly as our treasure depletes even further as two wars rage on abroad and the economy only limps along.

4. The medical establishment realizes that health reform is inevitable, so it is best to join the team to help shape it than to fight it. (This happened in Canada.) The American Medical Association has endorsed the plan, but the AMA is no longer representative of practicing doctors. There does not appear to be a sufficient medical force promoting what has been put forth so far.

5. A resurgence of working class organizations and unions. This seems to be on Obama’s side. Organizing new political groups continues on the heels of the stunning organizational capabilities of Obama’s campaign, but others may have learned new tricks and will launch their own advocacy groups. I see a good one on the horizon. Stay tuned.

6. Our foreign affairs concerns, if not solved, must be stabilized. This depends on who you ask, but a lot of turmoil remains in the Middle East and we remain in the thick of it. Still lots of killing and too little progress on the ground.

7. The economy must appear to be on the mend (more jobs, less reliance on foreign oil, etc.). I don’t see enough green sprouts yet, and people are still losing homes and jobs.

8. Demands for health reform from powerful social or political groups. Obama has powerful allies here. And powerful opponents.

9. A weakening of current health care markets, such as an increase in “high profile” criticisms of for-profit HMOs. Well, people are pretty fed up, and yet the majority of Americans like the devil’s insurance they have more than the devil’s plan they don’t know.

10. A rise (or resurgence) in national pride and a return to the exercising of fundamental values such as caring for others. Well, I don’t see it yet. Maybe people are too busy trying to survive.

11. A savvy social marketing campaign for health care reform. Given that Obama won the election despite a thin resume, satisfying this factor should have been a piece of cake. But it appears that people want a lot more than well-delivered words and promises once someone wins.

12. A mechanism for rapid communication of ideas/programs that the public views to be in its own best interests and that successfully counters the fear tactics by opponents. We have the Internet, blogs, Facebook, text messaging, and Twitter, but these innovations are so sprawling that it is difficult to coordinate efforts. Furthermore, people tend to hang out in cyberspace with those who believe as they already do—just as in the non-virtual world.

13. Ideally some substantial degree of healing between Democrats and Republicans or at least a strong bipartisan agreement that health care must be enacted. Bipartisanship? Don’t see that anywhere in sight.

14. Meaningful lobby reform, cutting off to some extent powerful interest-group access. A big Obama promise that has been badly broken is coming back to poke him in his privates. Deals seem to have been made with corporate entities that have a lot more to gain from the plans floating about than do our people.

15. Public financing of elections, again, reducing the influence of powerful interests. Maybe someday, but not even on the horizon. One gets the sense that incumbents care more about retaining their jobs than adjusting our system to make for a more level playing field.

16. Agreement on the shape/scope of a health plan from among various health care reformers. So far those who favor health care reform have been unable to coalesce around a single plan.

17. A significant external shock (e.g., skyrocketing health care costs threatening the collapse of our economy, a major health care scandal, a plague or natural disaster or terrorist attack that injures large numbers of young and healthy middle and upper-income Americans, or other unfortunate occurrences that force change). Well, health care costs are skyrocketing, but the problem with what is being put forth is that no one quite understands it (Lord knows I have tried reading these monster documents and come away with an Excedrin headache) or how it will be funded.

So things still do not look good to me. Unless Congress makes even more sweet deals to buy votes, as was done for Nebraska, I doubt we will see anything in the near future. I say, start from scratch after more people get jobs and back into homes .

  • AC

    I taut, I tau, a putty tat–Nice toon Pat.  Now on to reading.

  • Khan Krum

    Did dat lil’ birdie doo doo on dat health coup bill?! =-O

  • Sassy

    Pat, I agree that the timing for the health care debate has been awful.
    In the last two days, I have heard and read very discouraging numbers about job prospects for two to three years out, and the deficits are difficult to comprehend.
    The only way health care legislation had any chance was on an incremental and bi-partisan level. The democrats defeated themselves on this one!

  • Touchet

    You know that 500 billion that sitting in the government coffers–left over from the stimulus bill? 

    Look for it to come up again along with the health care bill when the economy recovers.

    Should be right before Obama runs for president again.

    They will use it to buy off enough of the Senators to pass health care and he will get a huge kick back from the health care industry.

    Remember, there are no limits now for CEO advertisement of a candidate.

  • Stan Davis

    Great ‘toon, Pat.  The text is even better.

    Stan Davis
    Lakewood, CO

  • Touchet

    Remember, Obama is from Chicago Politics.  This is just the kind of back room deals they do.

  • PortiaElizabeth

    Pat — you’re a true visionary! Of course quite a few of us were wishing for the health care bill to get a DNR, but I was so afraid the Dems might actually get something done. Hahhah. I’ve been a Dem myself long enough to know they can’t organize a 2-car parade, but the fear was there.

    I love your artwork (as usual)! It reminded me that when I line my parrot’s cage, I try to always make sure the news stories about BO are face up. 

  • Sassy

    The Inspector General for the TARP funds issued a report warning that those funds did not do nearly enough and that we could be facing much deeper financial problems within two to five years.
    We are fast approaching melt-down even without revamping our entire health care system. Scary stuff for me!

  • karen for Clinton

    I tawt I taw a puddy tat.  I did, I did taw a puddy tat!

    I have a parrot and when there happens to be a well placed picture under his perch it just makes me warm and fuzzy on cleaning day.

    Excellent points and foresight.  Number 11 - his savvy marketing isn’t working as well these days because the kool-aid dose has reached the expiration date.

  • karen for Clinton

    serves me right, i should have read the comments!

    he does look like tweety – not THAT tweety, the cute little one…

  • Pat Racimora

    I didn’t copy–honest.  Just wanted a canary.

  • AC

    Your accent is better than mine.

  • FLDemFem

    What they need to do, which won’t cost anywhere near as much, is regulate the health care industry and the insurance industry. Make rules that they must follow or be fined heavily for each infraction. Take the hospital that Michelle Obama worked at, University of Chicago Hospital. It is supposed to be a not-for-profit hospital but the last year she worked there, the hospital made $100,000,000. That’s one hell of a profit for a not-for-profit business. At the same time they were raking in the moolah, they were turning away poor, uninsured people. That was Michelle’s job, to find other places to send them. This sort of thing must stop.

    Not-for-profit hospitals should be exactly that, and have to treat anyone who comes in the door, insured or not.

    Insurance companies must be made to pony up when their policy holders require their insurance to pay for illness and accident, without endless paperwork and runarounds.

    Health care corporations, such as the Frist family’s Humana, must be made to spend a certain, and large, percentage of their profits on community health care projects, such as free clinics, bloodmobiles, mammogram mobiles, etc.

    Health care should be regulated so that people cannot profit obscenely from other peoples’ misery and trauma. And regulation would cost a lot less than the boondoggle bills currently making the rounds.

  • lark

    What they need to do is to make underwritting illegal, that is, prohibit underwritting for all circumstances and all types of health care policies. Nothing else. Oh and require insurers to sell the product when the client or the applicant show them the money. Health insurance should be like buying anything else, a car, a can of Campbells soup. The product describes the benefits and the rest of the conditions – the applicant who need not be called applicant anymore but customer – buys whatever the paper says it is offering. NO UNDERWRITTING ALLOWED. Not that difficult.

  • Ani

    Funny — I didn’t think of Tweety at all when I saw yours –

    loved your ‘toon!!  And great points.

  • lark

    What they need to do is to make underwriting illegal, that is, prohibit underwriting for all circumstances and all types of health care policies. Nothing else. Oh and require insurers to sell the product when the client or the applicant show them the money. Health insurance should be like buying anything else, a car, a can of Campbells soup. The product describes the benefits and the rest of the conditions – the applicant who need not be called applicant anymore but customer – buys whatever the paper says it is offering. NO UNDERWRITING ALLOWED. Not that difficult.

  • Rich

    Wonderful Cartoon!
     
    This Obama health care bill needs to end.  It is like a building that was designed by too many designers, all of whom had different customers in mind and the architects never spoke to each other and then they tried to combine their designs based on the fact that each was trying to please their own customers, not the others.  AND no one knew what the budget was.  So when they finished trying to please everyone, the design made no sense and was way over what any customer could afford.  Now trying to remodel this monstrosity to some kind of a smaller structure would still make no sense and, yes, in those kinds of situations it is better to start over and design a building with a smaller budget in mind and getting rid of the customers whose demands make no sense based on the people’s needs and the budget available.   As part of starting over, not only do you have to eliminate some of the customers from the original building, but you also need to get rid of some of the old architects and add some new Republican ones.
     
    Rich

  • J.J. (The PUMA)

    Lark’s “simple” plan will kill insurance.

    Insurance works on the principle that people with simalar risks of loss are pooled together, with all paying premiums and the few who have claims getting the pooled money.  The only way no underwriting works is if you force everyone to have insurance.  (Thus the need for the individual mandate).  If you have no underwriying without mandatory coverage only the people with claims will buy insurance.

  • TeakWoodKite

    Give the Canary a cigar! 

    Great Pat and toon…..

  • lark

    I agree with you that underwriting is essential to insurance. But I just believe in my imagination that once you prohibit underwriting, the market will find a way to deliver insurance products like any other product – an exchange of goods. I have no idea what will happen next, but I kind of feel the market will DEAL WITH IT and come up with products.

  • Cindy

    AC—funny!!

  • lark

    I agree with you that underwriting is essential to insurance. But I just believe in my imagination that once you prohibit underwriting, the market will find a way to deliver insurance products like any other product – an exchange of goods. I have no idea what will happen next, but I kind of feel the market will DEAL WITH IT and come up with products. CHANGE EVERYTHING.

  • Cindy

    “Who dat? Who dat? Who dat say gonna beat dem (healthcare plans!)?”
    Sorry, but my Louisiana heritage just kicked in.

    Great cartoon and post, Pat! You are a clever little bird! Thank you for always making us laugh, and think.

  • Anonymous

    They already do regulate the healthcare system.  That is what is wrong with it in the first place.  It started back n the 60′s or 70′s I believe so that doctors could not over charge patients and it has become beyond ridiculous.  I am a medical coder and so I know how it works.  Everyone thinks the doctors get paid too much, when the reality is CMS (Centers for Medicare/Medicaid services) sets the pay.  They use relative value units (RVUs) and decide how many units a procedure or office visit can be paid and that is it.  then they get paid so many dollars per unit.  The doctors never, I repeat never, get paid that much.  All payers are allowed to pay what they think is reasonable, again based on what CMS says.  CMS keeps cutting doctors pay.  This year they cut it by 21 percent!  That is a huge cut!  Doctors are very unhappy right now and are not in favor of a government takeover because Government has regulated the crap out of the industry and that is why it is so poor now.  The doctor will not get paid if they cannot prove medical necessity and medicare denies most charges for more info, plus, it can take up to 2 years to get paid from the Government!  I would never ever be a doctor because the government tells you how to practice medicine and they discourage noe, experimental treatments!  I pray to God that the Government never gets universal Health Care and I think we’d have a better fix to the system if we got the Government out and put the doctors and business folks back in charge.  The Government destroys all it takes over.  Look at our eductaional system.  Do we really want Healthcare to have the outcomes our schools do???

  • Timmy

    The bill is dead. What needs to done next is buried Obamacare.

    Obamacare dead
    Tue Feb, 19th, 2010
    May the Devil rest its soul in Hell

  • Obamastolemyparty

    oops.  That above was me.  Here is info on RVUs if anyone cares to look.  The answer to our healthcare problems might be to get the Government out!

    http://www.nhpf.org/library/the-basics/Basics_RVUs_02-12-09.pdf

  • Anonymous

    Feb. 19th??

  • lark

    I called my two Senators and my Congresswoman and I said to them, all I want you to do is prohibit the practice of underwriting to the insurance industry. Do nothing else. And then write at the end of the bill – DEAL WITH IT.

    Of course that was a waste of time.

  • Breeze

    OT:

    Are You Capable of Decency, Rahm Emanuel? Today at 5:32pmThe newly-released mind-boggling, record-smashing $3,400,000,000,000 federal budget invites plenty of opportunity to debate the merits of incurring more and more debt that will drown the next generation of Americans. Never has it been possible to spend your way out of debt. So… let the debate begin.

    Included in the debate process will be opportunities for our president to deliberate internally the wisdom of this debt explosion, along with other economic, military and social issues facing our country. Our president will discuss these important issues with Democrat leaders and those within his inner circle. I would ask the president to show decency in this process by eliminating one member of that inner circle, Mr. Rahm Emanuel, and not allow Rahm’s continued indecent tactics to cloud efforts. Yes, Rahm is known for his caustic, crude references about those with whom he disagrees, but his recent tirade against participants in a strategy session was such a strong slap in many American faces that our president is doing himself a disservice by seeming to condone Rahm’s recent sick and offensive tactic.

    The Obama Administration’s Chief of Staff scolded participants, calling them, “F—ing retarded,” according to several participants, as reported in the Wall Street Journal.

    Just as we’d be appalled if any public figure of Rahm’s stature ever used the “N-word” or other such inappropriate language, Rahm’s slur on all God’s children with cognitive and developmental disabilities – and the people who love them – is unacceptable, and it’s heartbreaking.

    A patriot in North Andover, Massachusetts, notified me of Rahm’s “retarded” slam. I join this gentleman, who is the father of a beautiful child born with Down Syndrome, in asking why the Special Olympics, National Down Syndrome Society and other groups condemning Rahm’s degrading scolding have been completely ignored by the White House. No comment from his boss, the president?

    As my friend in North Andover says, “This isn’t about politics; it’s about decency. I am not speaking as a political figure but as a parent and as an everyday American wanting my child to grow up in a country free from mindless prejudice and discrimination, free from gratuitous insults of people who are ostensibly smart enough to know better… Have you no sense of decency, sir?”

    Mr. President, you can do better, and our country deserves better.

    - Sarah Palin

  • lark

    I agree. When you get to the hospital you will find a menu light up like at Mc Donalds. Tonsils out – 200. – One only 150.

    I want to know something. How do the plastic surgery business and other businesses such as chiroprators and acupuncturist that are not covered by insurance survive or thrive?

  • Obamastolemyparty

    Self pay.  If people want something, they will pay for it.

  • jwrjr

    Re: #15 – public election financing: this is the last thing that incumbents in general and Chicago politicians (i.e. Obama) want.

  • AnnieCarmel

    Bless you Sarah!

  • whoframedrudy

    “It is like a building that was designed by too many designers, all of whom had different customers in mind and the architects never spoke to each other and then they tried to combine their designs based on the fact that each was trying to please their own customers, not the others.”

     That also sound a lot like the Democratic Primary ‘Process’ — haha — that produced Obama.

  • Anonymous

    JANY 19TH

  • Doc99

    The Reid-Pelosi Politburo Bill is a jobs killer. Time to get out of the backrooms and start over.

  • kenoshamarge

    I have two Blue and Gold Macaws that are given appropriate newpaper images to defecate upon on a regular basis. They may not care, but it raises my spirits somewhat.

    Adorable little canary Pat!

  • imustprotest

    I am a parent of a physically and cognitively challenged child and I applaud Sarah Palin for calling out Mr. Emmanuel on his use of the word “retarded”.  The use of the word seems to have exploded with the current generation and it’s sad that someone in such a public position would stoop slow low instead of raising the bar on discourse and common decency.

  • Sassy

    Aside from the way this bill was crafted, and then loaded with bribes, I am most angry that democrats were more than willing to risk harm to seniors on Medicare…citizens of this country, who have contributed all their lives.
    Then the same democrats were prepared to spend millions of dollars to protect the “rights” of terrorists in civilian court, when there are alternatives.
    Would the republicans go after entitlement programs? Of course, but I don’t see them pandering to enemies of this country!

  • FLDemFem

    In 1992, I was T-boned by a semi while driving down the road in my pickup truck. I was in the hospital, Rockingham Memorial in Harrisonburg, VA, for 13 days. I had two x-rays a day to determine if my torn lung and ripped bronchi had healed enough to take out the chest tube. I was also on pain meds and antibiotics. I did not have health insurance at that time. The bill for the 13 days and meds, doctor fees, etc. was $5000. That’s right, five thousand dollars for 13 days in the hospital. I thought they had made a mistake and asked them about it. It wasn’t a mistake. I asked them how they charge so little for so much. Here is what they told me. That hospital doesn’t buy or build anything until the money is raised. They have no mortgages or loans to pay off. I understand that their rates are still reasonable to this day. If more hospitals were run like that one, we wouldn’t have this health care crisis.

    I think it’s criminal that corporations are permitted to make a profit off the misery and trauma of Americans. And all this health care bill is going to do is increase the profit margins for the hospitals and insurance people. It won’t do squat for the patients, no matter what the “experts” in DC say. After all, it’s not like they have to live with it or die for lack of it. They have their own health care plan, paid for by us. Why would they turn on their benefactors, the corporations, in favor of the people who elected them???

  • Pat Racimora

    Thanks Portia Elizabeth!
    Dems can’t organize a two car parade.  LOL!!!!

  • margaret

    Pat, you continue to outdo yourself with the most amazing cartoons!  Thanks for the good chuckle this one gave me

  • FLDemFem

    Guest, that wasn’t the sort of regulation I meant. The regulations should be for insurance companies and hospitals, so they don’t overcharge everyone in sight, and so they deliver the insurance payments and the care that they are supposed to. Doctors should be the last people who get their fees cut, as long as the fees are reasonable. What they should cut is jobs like Michelle Obama’s at the UofC hospital, which paid her a starting salary of $120,000 which was raised to $317,000 when her husband tossed some pork their way, one million dollars worth. Imagine how much health care her salary could have funded. It would have probably paid the costs of treating the people she turned away to other hospitals and clinics. I think all hospitals should be non-profit. No one should make money off other peoples’ misery unless they are providing the care or medication. And even that should have a ceiling on it. We can come up with all sorts of programs to encourage doctors to treat people because they need it rather than because they can afford it. One way would be to forgive student loans used for medical school for doctors who work below a certain salary level and work in difficult venues. The main reason I hear for high doctor fees is that they have to pay back student loans and also carry malpractice insurance. Perhaps something could be addressed to share the cost of malpractice insurance, or to lower the rates for it. There are lots of ways we can lower health care costs, which would put decent health care in the reach of every American. But that can’t happen until the corporations stop sucking profits out of the health care system. It’s not regulation that’s the problem, Guest, it’s the greed.

  • FLDemFem

    While I totally agree with Ms. Palin on this subject, I just have one question. What makes her think that Obama is Rham Emmanuel’s boss?? It seems to me that it’s the other way around. Just sayin’
    ;)

  • Pat Racimora

    FEBRUARY 2011  START UPDATED COMMENTS HERE

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