Campaign Desk

07:00 AM - December 7, 2009

The Most Underreported Health Reform Story

And the senator from Nebraska

You might say the media have missed both sides of the Nelson story: the political story—his insurance connections and what they might say about the positions he takes—and the people story—the importance of the CLASS Act to changing the way Americans receive and pay for long-term care, and how it can be fixed in the legislative process to answer the CMS actuary’s legitimate concerns. Here’s a solid news package all rolled into one. Dot connection! Dot Connection! Dot Connection!

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Trudy Lieberman is a fellow at the Center for Advancing Health and a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for The Second Opinion, CJR’s healthcare desk, which is part of our United States Project on the coverage of politics and policy. Follow her on Twitter @Trudy_Lieberman.

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Ben Nelson was the target of liberal groups for months for his sabotaging of the Health Care policy process. The untold story is that when liberal ads were making progress on changing Ben's mind, Rahm Emmanuel jumped in and tried to shut it down. The Obama Administration has the back of people who are sabotaging their own health care initiatives.
http://www.politico.com/news/stories/0809/25900.html
Activists want to get information out on people like Ben Nelson, but they're stuck in, what firedoglake calls, the veal pen.
http://fdlaction.firedoglake.com/2009/08/07/rahm-goes-apeshit-on-liberals-in-the-veal-pen/
There's a really big split in the dems between DLC, corporate owned, conservative lite, Rahm Emmanuel type, dems and progressive, populist, Howard Dean type dems.
Obama adopted the tactics and words of the Howard Dean dems because they do win elections when given a chance, like in 2006 and 2008.
But Obama is rooted and surrounds himself with the conservative, Harold Ford type, dems and they are weak on policy and promises. They backbite and attack each other. This is the reason why the dems have an enthusiasm gap these days to the republicans because Obama punches the people who are active for him in the mouth and coddles those who are against him to his breast.
Ben should be getting pounded right now for violating basic party discipline, but instead its the people on the outside who are trying to hold him to account that are getting pounded by Obama's people. It sucks,

#1 Posted by Thimbles, CJR on Mon 7 Dec 2009 at 03:37 AM

The other story about another senator is how on top Al Franken has been on the health policy.
http://videocafe.crooksandliars.com/heather/sen-al-franken-debates-health-care
http://crooksandliars.com/susie-madrak/wendell-potter-says-franken-bill-will

It'd be nice to hear more about policy from people like Franken, who is well read on the issues and advocates the right policies, rather than Nelson, Kent Conrad (who has been awful awful stupid during this whole process. go google "conrad private health care france" and see for yourself), and the death panel republicans rant in support of the wrong policies.

#2 Posted by Thimbles, CJR on Mon 7 Dec 2009 at 01:32 PM

These politicians, excepting Franken who definitely does have a clue and does his homework, are signs of a crumbling cultural orientation. See "The Ethics of Sustainable Healthcare Reform." http://healthafteroil.wordpress.com/2009/05/01/the-ethics-of-environmentally-responsible-health-care-a-conversation-with-jessica-pierce-phd/

#3 Posted by Dan, CJR on Mon 7 Dec 2009 at 02:16 PM

I think the article does not accurately portray the CLASS Act; it does not allow for payment for nursing home care but rather in home services that would avoid a nursing home. See my article in BMJ http://www.bmj.com/cgi/content/full/339/oct26_1/b4398

#4 Posted by Bob Roehr, CJR on Mon 7 Dec 2009 at 02:22 PM

CLASS is not the solution for long-term care. It is merely a Trojan horse for what will follow-a new entitlement program that's taxpayer paid. CLASS can not work as a voluntary plan unless it is priced far below sustainability. But the drafters wisely set it so no benefits are paid for five years. At that point taxpayers can expect to be bailing out this program. If it is priced to be viable (berween $1500 and $2000 per-person per-year), consumers won't enroll. When nearly 50 Senators vote against something, including a dozen Democrats, shouldn't we all be alarmed that this is not the solution that best serves aging seniors or the American public at large.
Jesse Slome
Executive Director
American Association for long-Term Care Insurance
http://www.aaltci.org

#5 Posted by Jesse Slome, CJR on Mon 7 Dec 2009 at 02:56 PM

Wait a minute, Jesse Slome - did you just point talking points from, and a link to, an insurance industry website? Exactly how much credibility do you expect this readership to attach to that information? To put it a bit more crudely: My god, how stupid do you think we are?

#6 Posted by Angie Coiro, CJR on Mon 7 Dec 2009 at 04:57 PM

With abortion and long term care being neck and neck with self interests seeming to be the driving forces, all I can say is heaven help us.

Idiocy rules when teh question of waiting five years to apply for long term care as it is apparent that the drafters know nothing about long term care, costs, care needed .... many people will have reached the need for Medicaid.

And I am disgusted with abortion being the whipping boy of politicians, Most of the whippers are men who will never carry a fetus in their bodies. Sometimes there are situations in which it is better to abort than to force the infant to undergo horrific strategies with outrageous costs that leave parents and families homeless and penniless. Since when does the Catholic Church have the right to the last word? Please tell me when the word of US Bishops became the foundation for making laws or did I miss something many years ago in the Constitution? I encourage you to read SAVING GRACE at http://www.truthout.org/1203097

#7 Posted by memci, CJR on Mon 7 Dec 2009 at 06:03 PM

I knew by his actions and statements he had to be closely tied to drug and hospital corporations--now you tell me the reason. THANKS!!! He's pushing this business of no abortion like South Dakota did and then the women have to vote the state senators out and the bill was redone and it failed. Nebraska is so lowly populated and he refuses to allow the women in 49 other states to think for themselves. Why can't these "religious" characters remember "Render unto Caesar the things that are Caesar's, and to God the things that are God's." Since history was written there has been abortion of some sort for various reasons. Why not now??

#8 Posted by Patricia Wilson, CJR on Mon 7 Dec 2009 at 07:54 PM

Trudy Lieberman has offered her perspective on the politics of CLASS. Some of us are writing regularly on the substance of the debate over this very important--and very controversial idea. Here are some links to my own blog posts on the subject, as well to to some of my recent Kaiser Health News columns.

http://www.kaiserhealthnews.org/Columns/2009/November/113009Gleckman.aspx

http://blog.howardgleckman.com/

#9 Posted by Howard Gleckman, CJR on Mon 7 Dec 2009 at 09:00 PM

As a general comment it's very dispiriting to see the level of commentary on this issue as exemplified by this article and comments. Do you really think that the health insurance companies are evil? What about the non-profit insurance companies, are they just plain nasty too?

It's easy to look at this cynically from both sides. A big reason why the Dems are pushing this - against significant voter disapproval - is to lock in benefits for their voter base. Adding jobs and members to public employee unions is a big plus too. And the reason why no one is talking about tort reform is because they are the Dems bread and butter.

My take is that it is pure unadulterated madness for the US to add a huge new entitlement program during a time of recession and huge deficits. I'm sure you will think I'm evil for having that opinion, too...

#10 Posted by JLD, CJR on Tue 8 Dec 2009 at 03:57 AM

Insurance agencies aren't evil, they are merely motivated against the interests of their customers because they prioritize the interests of their shareholders. And maybe if customers had choices - instead of being locked into their employer's subsidized choices or forced to shop alone without the benefit of a pool prices, maybe if medical services weren't essential services - meaning customers could negotiate over their coverage and people who can't get private coverage because of preexisting conditions weren't inconvenienced, maybe if insurance companies didn't have state by state monopolies and exceptions from the government that protected them, then maybe we wouldn't be complaining about how evil the insurance companies are because they wouldn't have the opportunity.
But the fact is they do, so they are, and that because they are taking advantage of the rules of the game.
So it makes perfect sense to change the rules of the game when the current game is faulty.
What would make even more sense is to change the game completely, as is done in other countries, and socialize the whole system. Be thankful that option was taken off the table long ago.

#11 Posted by Thimbles, CJR on Tue 8 Dec 2009 at 04:47 AM

Just last week you were railing against "marauding insurance companies" being allowed to sell across state lines, and now you decry "state monopolies"? Which is it? Are insurance companies evil because they want to cover multiple states or are they evil because they don't?

Obamacare will lock in all the worst aspects of the current system while raising costs. It's an Obamination.

#12 Posted by JLD, CJR on Tue 8 Dec 2009 at 07:44 PM

The issues are different. Currently, states set their own rules to guide the industry and protect their consumers. This is helps us see which approaches work and which don't, such as Texas - who has high costs and a high population of uninsured, and Massachusetts - who has high costs but a low population of uninsured. Insurance companies could set up shop and abide by the local rules but they prefer to rule selected fiefdoms where they can take advantage of the local rules.

It's a difficult issue. Do you prefer standardization or autonomy? The health exchanges are a way of putting some standardization into the game.

But what the insurance companies want is something different. They want to sell policies across state lines. That way they can move to the state with the worst consumer protections and the least regulations and sell policies originating from that regulatory environment everywhere.

It undermines autonomy, the state's power to regulate. This is what happened to bank laws and credit card companies when federal regulators allowed banks to use the regulations of their home states to craft financial products nationally.
http://www.pbs.org/wgbh/pages/frontline/video/flv/generic.html?s=frol02s4bdq7a&continuous=1 (good program by the way)
They moved to the best state en masse and took consumers nationally to the cleaners. That game doesn't work so well for the consumer AT ALL.

#13 Posted by Thimbles, CJR on Tue 8 Dec 2009 at 09:43 PM

In order to welcome Christmas and New Year, our website hasMBT shoes on clearance to feedback customers. Now you can get the same quality styles of MBT shoes on clearance. Just because they are sold at a discount does not mean it is an imitation or a damaged style.

#14 Posted by MBT shoes on clearance, CJR on Sat 12 Dec 2009 at 02:34 AM