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Sen. Bernie Sanders responds to a caller on Washington Journal who feels, as I'm sure a lot of often do, like throwing his hands up in the air and giving up when looking at the terrible direction this country has been headed for so long now.

Sanders: Mike you know, dispair is really not an option. If you're saying to me that our friends on Wall Street who's greed and wrecklessness and illegal behavior plunged this country into the recession that we're in right now, and that want to go back to the way they used to be and give themselves huge bonuses and so forth and so on, and you're telling me that the heads of the insurance companies and the drug companies have enormous power are fighting for their own interests and their own profits at the expense of everybody else, you're absolutely right. That is the reality.

But dispair is not an excuse. You can't say you give up. We can't give up. I've got four kids and six grandchildren -- beautiful kids all of them. I can't give up. You can't give up. What we have to do -- this is tough stuff -- is figure out how did we get to where we are right now.

Was it a wonderful idea as Alan Greenspan told us, as President Bush told us and some Democrats told us that we want to deregulate everything, let Wall Street do whatever they want... is that a good idea? Is it a great idea that the Supreme Court recently said corporations are people and they can contribute as much money as they want to the political process? Is that a good idea? It's a horrendous idea, but reality is clear. We don't talk about it terribly much in Congress or on T.V.

A small number of people who have incredible wealth and power control a lot of what goes on in America. That's the simple reality. But throwing your hands up and saying it's too much; I can't deal with it, or you can say, this is tough stuff. This is tough stuff and how do we once again bring ordinary people into the political process. How do you create a government that works for the middle class rather than the wealthy. It ain't easy. But giving up is not an option.

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Unbelievable. Everyone knows the Republicans think we need absolutely no regulation of anything what so ever but they generally don't say it out loud this bluntly. Of course we didn't get any follow up from David Gregory asking him how being smart has anything to do with making insurance companies behave.

Gregory: You don't want government in charge of health care, yet you're a supporter of portable health insurance; the ability to take health insurance across state lines, but I thought the Republicans were states' rights guys and didn't want -- because you'd have to have some kind of Federal regulatory agency to monitor that kind of portability, wouldn't you?

Boehner: No, you wouldn't have to. What we're saying is the American people ought to buy health insurance across state lines. They ought to buy health insurance where they get the policy that they need for themselves and their family at the best price.

Gregory: And there wouldn't have to be some sort of Federal regulatory agency...

Boehner: Well no! That's the whole point. The President said I'm for that but you know there has to be some bureaucrat in Washington that needs to make sure that this is done fairly. The American people are smart enough to do this on their own.

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(FDR - keeping it plain and simple)

On November 29, 1935 President Roosevelt delivered an address to a crowd estimated at 100,000 in Atlanta Georgia. His subject was the Budget, Bailouts and Big Business. A reminder that, in 1933 our entire financial system was in ruins - the result of reckless investments, no oversights and shameless greed. Sound familiar?

Pres. Roosevelt: “Into the ears of many of you have been dinned the cry that your Government has been piling up an unconscionable and back breaking debt. Let me tell you a simple story. In the Spring of Nineteen hundred and thirty-three, many of the great bankers of the United States flocked to Washington. They were there to get the help of their government in the saving of their banks from insolvency. To them I pointed out, in all fairness, the simple fact that you couldn’t make bread without flour. The simple fact that the government would be compelled to go heavily into debt for a few years to come in order to save banks and save insurance companies and mortgage companies and railroads, and to take care of millions of people who were on the verge of starvation. And every one of these gentlemen expressed to me at that time the firm conviction that it was all well worth the price and that they heartily approved”.

1935 looking back on 1933. And now it's 2010 looking back on 2008.

History often repeats - more times than is necessary it seems.

"If you like the health insurance you have, you get to keep it." Remember that? Yeah, except that now we're going to tax it and load it up with expensive co-pays and deductibles that will keep you from being able to actually use it! The part I can't figure out is, who does this make happy? Other than union busters, I mean.

You know, it would be slightly less awful if they didn't try to feed us this horse hockey about how our salaries will go up if they force out insurance costs go down with this tax. What planet are y'all living on?

Reporting from Washington - President Obama told top Democratic House members on Wednesday that he favored a tax on insurance companies offering more expensive healthcare plans as a means of extending insurance to millions of people who are not covered, according to a person familiar with the meeting.

The "Cadillac tax" is a feature of a healthcare bill that cleared the Senate before the Christmas holiday. But the House has chosen another financing method -- a tax hike on the wealthy.

Powerful labor unions at the core of the Democratic base are opposed to the Cadillac tax, saying that in some cases union members gave up wage increases in return for richer healthcare benefits.

Obama's preference may put pressure on the House to adopt the Senate tax as part of a compromise between the two bodies. Obama made his views known at a late-afternoon meeting with House Speaker Nancy Pelosi (D-San Francisco) and other senior Democrats.

Hours earlier, White House Press Secretary Robert Gibbs was asked by reporters whether Obama preferred the Senate tax or the House version. "I have not heard him weigh definitively in one versus the other," Gibbs said.

Wednesday's meeting, the second in two days, was part of a White House effort to take a more active role in healthcare negotiations as they reach their final stage.

House and Senate leaders are trying to strike a compromise and send a bill to the president's desk before his State of the Union speech in the coming weeks.

The more active role is a change for the White House, which for months gave wide latitude to Congress as it shaped a bill.

A Senate aide who requested anonymity because he was not authorized to discuss the closed-door meetings said that the White House had signaled it would "convene and run" meetings from now on as lawmakers strive to reach a consensus, reflecting a "significant uptick" in the Obama administration's involvement.

The Democratic leadership welcomes a more hands-on White House, as Obama's imprimatur could provide political cover to members casting a tough vote in an election year.

"The White House recognizes that it's time to step up," said Chris Jennings, a senior healthcare advisor in the Clinton administration. "They need to spend capital in order to get this over the finish line. It can be extremely helpful because, fundamentally, you don't want to delay any longer than you have to. Their involvement can accelerate this from a political and technical perspective."

I'm not getting my hopes up. But it sure would be nice if the House started thinking more about those of us who are hurting instead of their own reelections:

WASHINGTON (Dow Jones)--U.S. House leaders signaled Tuesday they are willing to agree to a final health overhaul bill without a government-run health insurance option if other parts of the bill would fulfill the same goals.

House Speaker Nancy Pelosi (D., Calif.) said after meeting with senior House Democrats that the bill must meet the test of "holding insurance companies accountable," whether or not it includes a public option.

"There are other ways to do that, and I look forward to discussing those other ways. ... We will have what we need to hold the insurance companies accountable," Pelosi said.

Pelosi huddled with House committee chairmen as talks between the House and Senate on reconciling competing versions of the health care overhaul bill got underway Tuesday. House leaders are to meet with Senate leaders via teleconference at the White House on Tuesday evening. They are aiming to strike a deal by early February.

Rep. Chris Van Hollen (D., Md.), one of Pelosi's top lieutenants, said House leaders will expect concessions from Senate Democrats, including possibly a repeal of the antitrust exemption for insurance companies, if the public option is absent.

"Especially if you were not to have a public option, that would be important," Van Hollen told reporters. "The whole purpose of getting rid of the exemption would be to make sure you police competition so you cannot collude."

And on the more candid side:

Speaker Nancy Pelosi had little to say this afternoon at a press conference following a meeting between House leaders and health care principals. She and other members acknowledged that a number of differences must be resolved between House and Senate bills before a final reform package can be signed in to law--and all are aware that too much tinkering could upset a delicate balance in the Senate, where legislation often must meet a supermajority threshold.

But Pelosi did toss a jab President Obama's way.

Referring explicitly to one of Obama's campaign pledges, a reporter asked Pelosi whether C-SPAN cameras would be allowed to film the House-Senate negotiations.

"There are a number of things he was for on the campaign trail," she said, without addressing the question.

Oh, snap!

This is my first post to the C&L community. Since my book on the future of the American labor movement (A New New Deal: How Regional Activism Will Reshape the American Labor Movement) came out a few months ago, an important new case study developed that is worth examining. I wanted to use this as an opportunity to share my perspective on political lessons that we can take away from the health care debate. I arrive at the following conclusion: unless progressives change how we do politics, we will never get what we want from Washington.

As Congress prepares to pass health care reform (now that the Senate passed its bill today), most talk among progressives centers on whether we should be satisfied with a piece of legislation that has been diminished and compromised. But regardless of what we make of the final agreement, the real lesson from the health care debate is a political one: Unless we change how we do politics, we will never get what we want from Washington.

It is not insignificant that 35 million Americans will be receiving something more than they had before in terms of health care. Yet even with a progressive president and a supermajority in the Senate’s Democratic caucus, we are left to quibble over piecemeal legislative victories, passed only with huge concessions to corporate interests.

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("All the seasons changed and all the reasons changed")

"Any plan I sign must include an insurance exchange -- a one-stop shopping marketplace where you can compare the benefits, costs, and track records of a variety of plans -- including a public option to increase competition and keep insurance companies honest."

- President Obama - Weekly Radio Address - July 17, 2009

So . . . what happened?

Hell has officially frozen over. After more than a decade of hyper-partisanship and knee-jerk, reactionary opposition to the other, the entire political spectrum of Meet the Press's roundtable panel--Markos Moulitsas, Joe Scarborough, Ed Gillespie and Tavis Smiley--all agree on one thing: the health-care reform bill sucks. There's the vaunted bipartisanship Obama sought.

Laughing off Whiter House adviser David Axelrod's spin of the historic (and not-as-bad-as-it-seems) nature of the bill, Markos points out that all this bill does is expand an already broken system, a proven failed program in Massachusetts. Scarborough adds that for all the White House talk that the insurance companies hate the bill, there is no regulation that Congress didn't capitulate on after pushback from the insurance lobbies and if they hate it so much, why has the value of their stock gone up so much recently? Former RNC Chair Ed Gillespie can barely contain his glee at the thought of the seats the GOP will pick up, because of this bill, and Smiley notes that Candidate Obama's rhetoric doesn't measure up to President Obama's actions and bemoans the incrementalism mentality:

I do believe that you have to stand on your principle. With all due respect to the White House and the President, who deserves who deserves great credit for taking this issue on and pushing further down the field than any other seven Presidents have done, you still have to ask, where is the principle that we started out with, and how firm have we stood on that principle? I thnk the danger for this White House is this: that the President and his team appear to be incrementalists. I warned the last time I was on this program, quoting Dr. King, about taking “the tranquilizing drug of gradualism.”

I love that line, and it resonates as much today as it did when Dr. King tried dissuade those who wanted to take an incremental approach to civil rights and segregation.

The sad thing is how clear this is to us here outside the Beltway, and how badly calculated this was to those inside the White House. And I don't think this was some malevolent intent on their part, but just a triangulating, DLC/Centrist move that completely didn't take into account that we now inhabit the post-Clinton/Bush era. I don't think there's any question that the White House must accept responsibility for the lameness of the bill--although they'll never do it publicly and risk giving more fodder to the GOP media--Feingold and Webb are already pointing fingers.

And at this point, I don't know what can be done to make this better. Tempting as it might be to thrown in the towel, the ramifications of that politically (you throw a bone like that to the GOP and nothing will get through Congress next session) will be a nightmare, and besides which, there's no guarantee they'd be able to achieve anything, much less anything better on a second go-round. So all in all, I have to agree with Joe Scarborough, as much as it deeply pains me to do so: we've been screwed.

I scratched my head the other day when I heard that Sarah Palin had been invited to be a celebrity guest at a fundraiser for Canadian hospitals. Palin has railed against the Canadian health care system and continues to spread fear and lies about health care reform and lead the right wing rallying cry to keep Americans enslaved to giant insurance companies.

I don't know what genius came up with the idea, but apparently, the backlash was so great that organizers had to rescind their invitation:

HAMILTON, Ont. - Sarah Palin has been given the boot as a celebrity fundraiser for hospitals in Hamilton, Ont., but she will come to town raise money for a local children’s charity instead.

Palin has brought the American health care debate to Canada and it is causing a storm of controversy as concerned hospital supporters have protested her appearance to raise money for two local institutions in April.

The former vice-presidential candidate was supposed to speak at a fund-raising event for the Juravinski Cancer Centre and St. Peter’s Hospital in Hamilton. But a backlash of negative publicity cancelled those plans. Read on...

You may recall Palin being punked last month by Canadian comedian Mary Walsh, who posed as a conservative reporter. Palin told Walsh, “Canada needs to dismantle its public health-care system and allow private enterprise to get involved and turn a profit.”

Which made her a perfect candidate to come to Canada to raise money for their hospitals? I'm still scratching my head on this one...

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Information always has a soothing effect on me, and I'm feeling much calmer after tonight's White House conference call. Obama advisor David Axelrod and White House Health Reform Director Nancy-Ann DeParle took the time to answer our questions.

I started by asking about the recent maneuver to block imported drugs. I said it was "shameless," not only because Candidate Obama ran on the issue of allowing Americans to buy cheaper drugs from Canada, but because the FDA already does site inspections in those same plants they were calling unsafe. (Basically, in order to sell any drugs in America, your manufacturing facility must meet the same standards as an American plant.)

I was pleasantly surprised to hear that they would be submitting an HHS bill in the near future - they'd "just this week" gotten funding to address any safety concerns, but more importantly, to start putting an infrastructure in place to import drugs.

My other question (as a former reporter who frequently covered insurance corruption) was about using state insurance commissioners to enforce new insurance regulations.

I said that in many states, insurance commissioners were pretty much owned by the local insurance companies, and I was skeptical as to whether making them the enforcers would actually work.

DeParle said HHS Sec. Kathleen Sebelius, a former state insurance commissioner, was not one of "those" commissioners, and she would be overseeing state departments. Sebelius already met with state insurance commissioners, she said, and having found a wide discrepancy in authority from state to state, got language inserted in the bill that would give them additional powers. (DeParle noted that the West Virginia commissioner didn't even have the authority to see if insurance companies were solvent.)

DeParle said this was the widest expansion of insurance regulation in 20 years.

David Axelrod also chimed in, noting these changes were part of the reason why the insurance industry has opposed the bills so stringently. If this was a giveaway, he said, they wouldn’t be lobbying so hard to defeat the bill.

I have to give it to Axelrod on this: Without even a little exaggeration, I'd say that standardizing state oversight is probably the insurance industry's worst nightmare. They've always taken advantage of a hodgepodge of weak state regulations, sprinkling generous political contributions along the way to buy off state legislators. So this bill is really what you want from federal regulation: Overriding weak state laws that trample consumers.

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The rightie tighties have their knickers in a wad because Jane Hamsher decided to point out that Joe Lieberman's wife not only made large sums annually on the payroll of insurance companies -- which creates a clear conflict of interest for Lieberman in taking a lead role in killing health-care reform -- but also in fact collects money from the Susan G. Komen Foundation as a "global ambassador" for women's health. Jane organized a campaign to have her removed.

Factually and logically, Jane's right that it's silly for outfits like Komen to be underwriting someone who has so badly damaged the ability of millions of women to obtain health-care insurance. But facts and logic have nothing to do with the world of right-wing nutcases.

Particularly those at Fox, who have been avidly denouncing Hamsher's campaign as "outrageous" and using it to paint Lieberman as a martyr of "the far left." Bill O'Reilly, among others, devoted a large chunk of last night's O'Reilly Factor, including his Talking Points Memo, to denouncing the campaign as "sickening" and "disgraceful."

The Giant Turnip of Wingnuttia, aka Glenn Beck, was particularly vicious. He devoted a whole segment to calling Hamsher out, holding up a reproduction of her infamous Lieberman "blackface" Photoshop from 2006 and repeatedly referring to it.

Having once worked for Jane, I can attest to the fact that she sincerely regrets having run that shot, and not just because it's constantly used to slap her down. But really, this is the kind of argumentation we've come to expect from Beck, a la his attacks on Van Jones and Anita Dunn: Latch onto a single rhetorical mistake, then play it over and over as though that's what the person is about.

Well, hey, that particular game is a two-way street. The only problem with Beck is that, as our Fearmonger in Chief, he gives us almost a daily example of complete asshattery that should in fact permanently discredit him. To wit:

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Where to start?

But hey, it's not as if any of us can afford antidepressants, anyway!

In the meantime, bankers are doing better than ever and Joe Lieberman has decided that insurance companies are more important than you or your family. The Democrats haven't delivered on even one major promise and that light at the end of the tunnel sure does look like an oncoming train. Why wouldn't you be depressed?

More than half of the nation’s unemployed workers have borrowed money from friends or relatives since losing their jobs. An equal number have cut back on doctor visits or medical treatments because they are out of work.

Almost half have suffered from depression or anxiety. About 4 in 10 parents have noticed behavioral changes in their children that they attribute to their difficulties in finding work.

Joblessness has wreaked financial and emotional havoc on the lives of many of those out of work, according to a New York Times/CBS News poll of unemployed adults, causing major life changes, mental health issues and trouble maintaining even basic necessities.

The results of the poll, which surveyed 708 unemployed adults from Dec. 5 to Dec. 10 and has a margin of sampling error of plus or minus four percentage points, help to lay bare the depth of the trauma experienced by millions across the country who are out of work as the jobless rate hovers at 10 percent and, in particular, as the ranks of the long-term unemployed soar.

Roughly half of the respondents described the recession as a hardship that had caused fundamental changes in their lives. Generally, those who have been out of work longer reported experiencing more acute financial and emotional effects.

Time to make noise! They allowed a cap to go through to get a lower CBO score, but how do we know what we'll get instead? Let your congress critter know they don't have their priorities straight. If you get cancer, you shouldn't have to lose your house to pay for it.

WASHINGTON — A loophole in the Senate health care bill would let insurers place annual dollar limits on medical care for people struggling with costly illnesses such as cancer, prompting a rebuke from patient advocates.

The legislation that originally passed the Senate health committee last summer would have banned such limits, but a tweak to that provision weakened it in the bill now moving toward a Senate vote.

As currently written, the Senate Democratic health care bill would permit insurance companies to place annual limits on the dollar value of medical care, as long as those limits are not "unreasonable." The bill does not define what level of limits would be allowable, delegating that task to administration officials.

Adding to the puzzle, the new language was quietly tucked away in a clause in the bill still captioned "No lifetime or annual limits."

As Marcy points out, this is another cute deal:

So what Ezra’s sources really mean is that the Senate bill–partly because it has traded off other means to keep premiums down–has had to eliminate a key promise of health care reform: that families experiencing a catastrophic health care event wouldn’t lose coverage at the time they needed it the most. What Ezra’s sources really mean is that, because they chose not to pursue other strategies which would have made it unecessary to eliminate the cap, they have instead been forced to eliminate the caps to keep the bill competitive with the House bill.

Don’t let Harry Reid fool you. The problem is not that health care “premiums would go through the roof” without caps. The problem is that Harry Reid has deliberately chosen not to use other means to prevent health care premiums from going through the roof, means that wouldn’t mean families bear the brunt of the problem.

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(h/t Heather.)

First of all, I'd like to reiterate that yes, a bill without a public option can serve the same purpose as the public option: namely, to force efficiency and competition. So yeah, I do see this as a win - and so does Nate Silver. And I don't buy the insurance company "we won" mantra just yet, because the Medicare buy-in proposal is a real threat to them. After all, the 55+ group is very profitable for them.

It seems clear the most important component of a plan lacking a public option is a mandated medical-loss ratio. But here's the most important detail of a requirement that companies spend 90 percent of each premium dollar on care: Who will be responsible for enforcement? In order to work, it's got to be the feds.

This is the most important part of the argument, because insurance companies (and their PACs) have enormous influence in state markets - and in state legislatures. State insurance commissioners are usually (not always) hired from the ranks of the industry, and are famous not only for rubber-stamping rate increases, but for far too often turning a blind eye to insurance company abuses.

What we want to watch in the Medicare buy-in is, are they going to take premiums (subsidies, whatever form it finally takes) into the Medicare trust fund? Believe it or not, it would be a very good thing if they did. A younger, healthier population would actually lessen the strain on the Medicare system. But I'm betting Republicans will shamelessly present it as "an assault on Medicare."

We also have to look at who gets to buy in - and why. Under the current proposal, people 55+ get to pick Medicare through the new exchanges in 2014. But what do we do until then? Well, they plan to allow them in starting in 2011.

Is this only for high-risk patients? Because it would really be a drain on the Medicare system (if the premiums went into the same system) if it was. It would be a bad idea anyway, because it would be too difficult to sustain if it was all people with pre-existing conditions.

Will the new Medicare members be charged the full cost? At 65, you're heavily subsidized for most of the cost, paying about $100 a month. The real cost is closer to $500. So will there be subsidies to purchase Medicare? Definitely, in 2014.

In the meantime? Not clear. This is one of the areas on which you want to lobby Congress.

You probably already know the problems with triggers - namely, that they're usually written in such a way as to make it highly unlikely they ever kick in. (That's why Queen Olympia loves them.)

As you might expect, we'll be watching closely.

You know, it really is depressing - and infuriating - to see how little will actually be accomplished with this so-called health care "reform."

And unless the House leadership waves a magic wand in the conference committee hearings, I doubt much will change:

Measured against the promises President Obama and congressional Democrats have made about health-care reform, the bill the Senate begins debating this week could be setting Americans up for disappointment: Some of the main reforms would not take place for several years, and even when they do, some observers say, the bill does too little to make sure they would be enforced.

Until 2014, insurance companies could continue to deny coverage or charge higher premiums based on people's medical history. Another highly touted reform -- banning annual and lifetime limits on coverage -- would take effect in 2010, but it would permit significant exceptions.

Even with those rules in place, "there's no power to really hold the insurance companies accountable," said consumer advocate Betty Ahrens, executive director of the Iowa Citizen Action Network. "It's toothless."

Jim Manley, a spokesman for Senate Majority Leader Harry M. Reid (D-Nev.), said the bill was a compromise. "This is not the legislation we would have written in a perfect world, but Senator Reid believes that this bill has the best chance possible to get the 60 votes necessary to overcome a Republican filibuster," Manley said.

The delay in implementing some key reforms contrasts with the urgency of Obama's call for action.

Although some changes might take years to implement, Obama said in July, "We shouldn't have to wait a long time to make sure that people don't lose their insurance because of a preexisting condition."

Delaying relief until 2014 means that Obama could face reelection -- and Congress be transformed by two elections -- before voters begin feeling the legislation's full effect.

Here's the real kicker: The feds won't even enforce their own laws. That's right, kids, it'll be left to the notoriously industry-friendly state regulators. The feds will only get involved under rare conditions.

Which means never. This is exactly what happened with HIPAA (Health Insurance Portability and Accountability Act). Insurers weren't allowed to make rescissions unless consumers defrauded the insurer or deliberately misrepresented their medical condition.

SS,DD.