Of course, being upset about this health insurance reform bill mandating Americans to buy private insurance is "having a tantrum" and especially when that health insurance reform bill comes with an tax on health insurance plans that actually would make employer-provided insurance worse for middle-class Americans.

It's also interesting how the White House lashes out at Howard Dean, but doesn't do so with Senator Lieberman. They prefer to pressure and twist progressives' arms into going along with this shit bill, and never have once applied pressure on any of the conservative Democrats, especially on Senator Lieberman. Here's an interesting quote from Lieberman that shows the WH and the Senate leadership refused to pressure him into supporting the public option, Medicare buy-in, and other issues:

Asked by HuffPost as he left the meeting if he was willing to give up his gavel -- his chairmanship of the Homeland Security Committee that he fought so hard to keep following the presidential election -- he dismissed the concern. "Oh, God no," he said. "Nobody's asking me that."

Yes, God forbid that anyone takes away Senator Lieberman's chairmanship, or even use that as a pressure point in getting him to go along with the health bill. This shows that the Democratic Party leadership, all the way up to the White House, failed to apply pressure to Senator Lieberman because they didn't want to. We do know that the President thanked Senator Lieberman in private:

Obama, who was described as upbeat in what was an otherwise serious meeting, responded: "Why don't we all begin to have some fun? Let's pass this bill." Obama thanked Lieberman privately for his statement issued earlier Tuesday pledging support for the bill as long as the Medicare expansion and public option were eliminated from the bill, Lieberman said.



Talk about having their priorities wrong here in enabling conservative Democrats and miscreants like Senator Lieberman to delay, obstruct, and hijack the process with their ransom demands.

Once again, here's what Dr. Howard Dean said on Countdown last night:



This is not real reform. It‘s not health care reform. There are no choices. The decision has been made without really thinking about it. It‘s been made because people are exhausted and they want to pass a bill so desperately they‘re not thinking about what they‘re doing here. It‘s been made to commit the United States to health care reform through the private sector. Now, I don‘t think that‘s a decision that should be made lightly. In the previous bills, the Medicare buy-in, the public option, had the choice of—mixtures of giving Americans the opportunity to make their own choices. Those choices have been taken away by the pro-insurance folks in the Senate. I think that‘s a mistake. Are there some good things in this bill? Yes. This is basically the Mitt Romney bill in Massachusetts, except it doesn‘t insure a higher percentage of people. The exchanges work well, although there‘s no cost control of any or any substance. You‘re going to be forced to buy health insurance from a company that‘s going to take, on average, 27 percent of your money so they can pay CEOs $20 million a yearly and so they can return have return on equity in their shareholders. And there‘s no choice about that. If you don‘t get that insurance, you‘re going to get—you‘re going to get a fine. So, this is—this is a bill that was fundamentally written by staffers who are friendly to the insurance industry. Held up so—and was friendly to the insurance industry by senators who take a lot of money from the insurance industry. And it is not health care reform. I think it‘s too bad it‘s just come to this. O‘DONNELL: And, Governor, the compromising isn‘t over. There are days left in this process at least, where we can expect even more compromises. What would be your advice to a senator, a Democratic senator on the floor of the Senate, on passage of this bill? The choices to vote, yes or no? DEAN: No, absolutely not. You can‘t vote for a bill like this in good conscience. It caused too much money. It isn‘t health care reform. It‘s not even insurance reform. Take, for example, this—there‘s a lot of talk about people who have pre-existing conditions can get health insurance. Well, not exactly. The fine print in the Senate says about health care industry—the health care industry gets to charge you three times as much if you‘re older than if you‘re younger. And they get to write the rules. That‘s in the Senate bill.



This bill is no longer reform.

... O‘DONNELL: And, Governor, as to Senator Lieberman, you were chairman of the Democratic Party, you recruited candidates all over the country. Did you say to them, “When you get into that Congress, and on the Democratic side, you‘ve got to be with us on every single vote”? I mean, how do—how do you police Democratic loyalty once the election is over? DEAN: You know, I‘m not going to get into that. Joe loves the attention, and just to make Joe the issue, I think, is a mistake. The issue is: are we going to have real health care reform or are we not? And evidently, we‘re not. But we still got to fight for it. And this isn‘t the end of the fight. This is a terrible disappointment. It‘s a disappointment to the American people. It‘s a disappointment to all of us who‘ve worked so hard for real reform. It‘s a disappointment, frankly, for people who thought they ought to have choices that the Senate shouldn‘t make for them and force them into buying insurance where 27 percent of the money comes off the top. But, that‘s—we are where we are, and we‘re going to keep fighting. We‘re not going to stop this fight.

Dr. Dean is right about private insurers still discriminating against you by charging older people who tend to have pre-existing conditions three times more than a younger person. The Washington Post has covered in extensive detail how private insurers will continue to cherry-pick, game the system, and still has theEXACT same clause that allows them to drop your policy based on material fraud.



This Senate bill actually makes your employer-provided coverage worse thanks to the excise tax, which will affect a huge portion of the middle class.

RJ Eskow:

Kaiser Health News has summarized some new findings from the Mercer consulting group that are quite compelling. We think they're so significant they should each be absorbed separately. The first impressive finding, from a study of 3,000 firms: "The excise tax ... could hit up to 19 percent of medical packages offered by employers in 2013, the first year it goes into effect." (Emphasis mine)

19 percent! As in one health plan in five - you know, that 19 percent. We don't have enough data to guess what percentage of people with employer health insurance would be affected, but we're predicting it will be more than 19 percent. Why? Because larger employers tend to offer more generous health coverage than smaller employers, and union health plans also tend to have larger memberships. So if one in every five plans will be affected, larger plans will be disproportionately taxed - with the effects of that tax being passed on to more than one American in five with employer-based insurance.

Jon Walker:

Help is being defined as giving insufficient subsides to Americans now forced by the government to buy extremely expensive, poorly regulated, junk insurance. Without banning annual limits and an extremely high out-of-pocket cap (which thanks to a massive loophole is not really capped at all), the insurance regulations are basically meaningless. Having this new, mandated “coverage” will not stop you from being bankrupted by accumulated medical debt should you get seriously ill. Insurance that does not protect you from financial ruin if you get sick makes a mockery of the entire concept health insurance. The harm this bill will do thanks to the excise tax on employer-provided insurance benefits is enormous. The health care bill is designed with the goal of making millions of middle class Americans’ health insurance coverage much worse. That is not a bug, it is a feature. The excise tax is meant to force your employer to cut back your insurance benefits, reduce your coverage, and increase your co-pays and deductibles. This is not the conclusion of partisan think tanks, bloggers, or activists, this is the conclusion of the non-partisan Congressional Budget Office (CBO) and the Center for Medicare and Medicaid Services (CMS). The CBO concluded: [A]n estimated 19 percent of workers with employment-based coverage would be affected by the excise tax in that year [2016]. Those individuals who kept their high-premium policies would pay a higher premium than under current law, with the difference in premiums roughly equal to the amount of the tax. However, CBO and JCT estimate that most people would avoid the cost of the excise tax by enrolling in plans that had lower premiums; those reductions would result from choosing plans that either pay a smaller share of covered health care costs (which would reduce premiums directly as well as indirectly by leading to less use of covered medical services), manage benefits more tightly, or cover fewer services. The CMS also concluded: In reaction to the tax, many employers would reduce the scope of their health benefits. The resulting reductions in covered services and/or increases in employee cost-sharing requirements would induce workers to use fewer services. Because plan benefit values would generally increase faster than the threshold amounts for defining high-cost plans (which are indexed by the CPI plus 1 percent), over time additional plans would become subject to the excise tax, prompting those employers to scale back coverage. To translate, they both conclude the tax will effectively force employers to scale back the health insurance benefits they offer in order to avoid the excise tax. This can be done by reducing what benefits the plan covers and/or increasing cost sharing (i.e. higher co-pays, higher deductibles, higher out-of-pocket limits, and possibly lower annual limits). If you have a good employer provided health insurance plan, it will be dramatically scaled back. Contrary to Obama’s direct promise, you will not be able to keep the coverage you currently have, and that is by design. The real problem with this excise tax on what are dubbed “Cadillac” plans is that it is not indexed to health care inflation. In the first few years, it will only affect high-end plans, but, after a decade, it would force employers to make the vast majority of employer-provided health insurance plans much worse. A decade after reform starts most Americans will have much worse health insurance coverage as a result.

You know that whole bit about bending the cost curve? You know what would've bent the cost curve down more than the excise tax? The Dorgan amendment would have saved the government hundreds of millions of dollars and helped lower the overall cost of health insurance for Americans.

This excise tax, which would reduce the quality of millions of Americans’ health insurance coverage, will technically “bend the cost curve” by just barely 0.3% in 2019. All that for a measly 0.3% reduction in national health expenditures. To give you a comparison, CBO projects that Dorgan’s drug re-importation would reduce spending on prescription drugs roughly $100 billion over the next decade (I think the savings could easily end up 4-5 times that amount). A $10 billion reduction in prescription drug spending compared to the total NHE spending last year, which was roughly $2.4 trillion in 2008, would be a 0.4% reduction in NHE. Dorgan’s bipartisan drug re-importation amendment would reduce NHE by basically as much as this excise tax. Except Dorgan’s amendment would reduce American’s out-of-pocket spending on health care, and not increase it like the excise tax. If this excise tax is the core of the plan to “bend the cost curve,” it is a failure. If the government took the simple and small step of using its size to negotiate better drug prices for all Americans (like every other industrialized nation), it would do dramatically more to reduce NHE than this excise tax that will reduce the quality of insurance for millions of Americans.

Right now, Democracy For America is gearing up to oppose the individual mandate in this shit Senate bill, and fighting for a real public option. They just sent out an e-mail to their supporters, including me:

Here's the deal, Senate leaders are all over Washington claiming they finally have a healthcare reform bill they can pass, as long as they remove the public option. After all, they say, even without a public option, the bill still "covers 30 million more Americans." The problem is that's not really true. What they are actually talking about is something called the "individual mandate." That's a section of the law that requires every single American buy health insurance or break the law and face penalties and fines. So, the bill doesn't actually "cover" 30 million more Americans -- instead it makes them criminals if they don't buy insurance from the same companies that got us into this mess. A public option would have provided the competition needed to drive down costs and improve coverage. It would have kept insurance companies honest by providing an affordable alternative Americans can trust. That's why, without a public option, this bill is almost a trillion dollar taxpayer giveaway to insurance companies. ... Without the choice of a public option, forcing Americans to buy health insurance isn't just bad policy, it's political disaster for Democrats -- a ticking time-bomb for years to come. Does anyone think Republicans won't use this against Democrats in 2010? What about in 2014 after the mandate goes into effect and the press reports all the horror stories of Americans forced to choose between paying their monthly health insurance bill to Aetna or paying rent? The mandate is toxic and Democrats will own it. By the 2016 presidential election, is there any wonder how this will play out for Democrats?

Thank you, Howard Dean for standing up for us.

UPDATE: Here's a MUST-READ by emptywheel on why mandating Americans leads us on a road to neo-feudalism.

UPDATE2: Gibbs directly goes after Dean!