By Susan Heavey
ABC News (Reuters), Dec. 16, 2009

WASHINGTON (Reuters) – Nearly 20 percent of the U.S. population — or almost 60 million people — went without health insurance at some point since January 2008, according to government estimates released Wednesday.

The analysis by the Centers for Disease Control and Prevention comes as Democratic senators wrestle to pass their version of health reform legislation before the end of the year to help make good on President Barack Obama’s top domestic goal of overhauling the nation’s $2.5 trillion healthcare system.

Much of the focus so far has been on how to expand access to health insurance in a nation where coverage is closely tied to employment but 10 percent of the work force in unemployed. More than 45 million people are uninsured.

While the CDC’s findings largely backed that figure, they also found 58.4 million lacked coverage at some point in the year prior to the survey, while 31.9 million — or nearly 11 percent — did not have insurance for more than a year.

Two-thirds of those who did not have coverage for at least part of the time were unemployed working-age adults. Those most likely to lack health coverage were Hispanics, men and young adults ages 18 to 24, the CDC found.

The CDC’s National Center for Health Statistics analyzed data on 32,694 people who responded from January through June 2009 as part of an ongoing survey.

At a time when much of the debate on the Senate bill has focused on its inclusion of a government-run “public option” insurance plan, the CDC found 20 percent of children and adults age 64 or younger are already covered by government health programs. Democrats plan to strip the public option before the full Senate votes.

The Medicaid program helps cover many of the poor, including children. Youth can also get care under the Children Health Insurance Program, which was extended by lawmakers earlier this year. Younger people with disabilities could also be covered under Medicare, which covers those age 65 or older.

One bright spot in the report: more children received health coverage, largely through the government.

The number of children enrolled in government health insurance programs also rose from 34.2 percent in 2008 to 37.4 percent in the first half of 2009, according to the study.

Overall, 8.2 percent of children still lack health care coverage, it found.

(Reporting by Susan Heavey, editing by Anthony Boadle)

By Glenn Greenwald
Salon.com, Wednesday, Dec 16, 2009 05:17 EST

Of all the posts I wrote this year, the one that produced the most vociferous email backlash — easily — was this one from August, which examined substantial evidence showing that, contrary to Obama’s occasional public statements in support of a public option, the White House clearly intended from the start that the final health care reform bill would contain no such provision and was actively and privately participating in efforts to shape a final bill without it.  From the start, assuaging the health insurance and pharmaceutical industries was a central preoccupation of the White House — hence the deal negotiated in strict secrecy with Pharma to ban bulk price negotiations and drug reimportation, a blatant violation of both Obama’s campaign positions on those issues and his promise to conduct all negotiations out in the open (on C-SPAN).  Indeed, Democrats led the way yesterday in killing drug re-importation, which they endlessly claimed to support back when they couldn’t pass it.  The administration wants not only to prevent industry money from funding an anti-health-care-reform campaign, but also wants to ensure that the Democratic Party — rather than the GOP — will continue to be the prime recipient of industry largesse.

As was painfully predictable all along, the final bill will not have any form of public option, nor will it include the wildly popular expansion of Medicare coverage.  Obama supporters are eager to depict the White House as nothing more than a helpless victim in all of this — the President so deeply wanted a more progressive bill but was sadly thwarted in his noble efforts by those inhumane, corrupt Congressional “centrists.”  Right.  The evidence was overwhelming from the start that the White House was not only indifferent, but opposed, to the provisions most important to progressives.  The administration is getting the bill which they, more or less, wanted from the start — the one that is a huge boon to the health insurance and pharmaceutical industry.   And kudos to Russ Feingold for saying so:

Sen. Russ Feingold (D-Wis.), among the most vocal supporters of the public option, said it would be unfair to blame Lieberman for its apparent demise. Feingold said that responsibility ultimately rests with President Barack Obama and he could have insisted on a higher standard for the legislation.

“This bill appears to be legislation that the president wanted in the first place, so I don’t think focusing it on Lieberman really hits the truth,” said Feingold. “I think they could have been higher. I certainly think a stronger bill would have been better in every respect.”

Let’s repeat that:  “This bill appears to be legislation that the president wanted in the first place.”  Indeed it does.  There are rational, practical reasons why that might be so.  If you’re interested in preserving and expanding political power, then, all other things being equal, it’s better to have the pharmaceutical and health insurance industry on your side than opposed to you.  Or perhaps they calculated from the start that this was the best bill they could get.  The wisdom of that rationale can be debated, but depicting Obama as the impotent progressive victim here of recalcitrant, corrupt centrists is really too much to bear.  

Yet numerous Obama defenders — such as Matt Yglesias, Ezra Klein and Steve Benen — have been insisting that there is just nothing the White House could have done and all of this shows that our political system is tragically “ungovernable.”  After all, Congress is a separate branch of government, Obama doesn’t have a vote, and 60 votes are needed to do anything.  How is it his fault if centrist Senators won’t support what he wants to do?  Apparently, this is the type of conversation we’re to believe takes place in the Oval Office:

The President:  I really want a public option and Medicare buy-in.  What can we do to get it?

Rahm Emanuel:  Unfortunately, nothing.  We can just sit by and hope, but you’re not in Congress any more and you don’t have a vote.  They’re a separate branch of government and we have to respect that.

The President:  So we have no role to play in what the Democratic Congress does?

Emanuel:  No.  Members of Congress make up their own minds and there’s just nothing we can do to influence or pressure them.

The President:  Gosh, that’s too bad.  Let’s just keep our fingers crossed and see what happens then.

In an ideal world, Congress would be — and should be — an autonomous branch of government, exercising judgment independent of the White House’s influence, but that’s not the world we live in.  Does anyone actually believe that Rahm Emanuel (who built his career on industry support for the Party and jamming “centrist” bills through Congress with the support of Blue Dogs) and Barack Obama (who attached himself to Joe Lieberman when arriving in the Senate, repeatedly proved himself receptive to “centrist” compromises, had a campaign funded by corporate interests, and is now the leader of a vast funding and political infrastructure) were the helpless victims of those same forces?  Engineering these sorts of “centrist,” industry-serving compromises has been the modus operandi of both Obama and, especially, Emanuel.

Indeed, we’ve seen before what the White House can do — and does do — when they actually care about pressuring members of Congress to support something they genuinely want passed.  When FDL and other liberal blogs led an effort to defeat Obama’s war funding bill back in June, the White House became desperate for votes, and here is what they apparently did (though they deny it):

The White House is playing hardball with Democrats who intend to vote against the supplemental war spending bill, threatening freshmen who oppose it that they won’t get help with reelection and will be cut off from the
White House, Rep. Lynn Woolsey (D-Calif.) said Friday.  “We’re not going to help you. You’ll never hear from us again,” Woolsey said the White House is telling freshmen.

That’s what the White House can do when they actually care about pressuring someone to vote the way they want.  Why didn’t they do any of that to the “centrists” who were supposedly obstructing what they wanted on health care?  Why didn’t they tell Blanche Lincoln — in a desperate fight for her political life — that she would “never hear from them again,” and would lose DNC and other Democratic institutional support, if she filibustered the public option?  Why haven’t they threatened to remove Joe Lieberman’s cherished Homeland Security Chairmanship if he’s been sabotaging the President’s agenda?  Why hasn’t the President been rhetorically pressuring Senators to support the public option and Medicare buy-in, or taking any of the other steps outlined here by Adam Green?  There’s no guarantee that it would have worked — Obama is not omnipotent and he can’t always control Congressional outcomes — but the lack of any such efforts is extremely telling about what the White House really wanted here.

Independent of the reasonable debate over whether this bill is a marginal improvement over the status quo, there are truly horrible elements to it.  Two of the most popular provisions (both of which, not coincidentally, were highly adverse to industry interests) — the public option and Medicare expansion — are stripped out (a new Washington Post/ABC poll out today shows that the public favors expansion of Medicare to age 55 by a 30-point margin).  What remains is a politically disastrous and highly coercive “mandate” gift to the health insurance industry, described perfectly by Digby:

Obama can say that you’re getting a lot, but also saying that it “covers everyone,” as if there’s a big new benefit is a big stretch. Nothing will have changed on that count except changing the law to force people to buy private insurance if they don’t get it from their employer. I guess you can call that progressive, but that doesn’t make it so. In fact, mandating that all people pay money to a private interest isn’t even conservative, free market or otherwise. It’s some kind of weird corporatism that’s very hard to square with the common good philosophy that Democrats supposedly espouse.

Nobody’s “getting covered” here. After all, people are already “free” to buy private insurance and one must assume they have reasons for not doing it already. Whether those reasons are good or bad won’t make a difference when they are suddenly forced to write big checks to Aetna or Blue Cross that they previously had decided they couldn’t or didn’t want to write. Indeed, it actually looks like the worst caricature of liberals: taking people’s money against their will, saying it’s for their own good — and doing it without even the cover that FDR wisely insisted upon with social security, by having it withdrawn from paychecks. People don’t miss the money as much when they never see it.

In essence, this reinforces all of the worst dynamics of Washington.  The insurance industry gets the biggest bonanza imaginable in the form of tens of millions of coerced new customers without any competition or other price controls.  Progressive opinion-makers, as always, signaled that they can and should be ignored (don’t worry about us — we’re announcing in advance that we’ll support whatever you feed us no matter how little it contains of what we want and will never exercise raw political power to get what we want; make sure those other people are happy but ignore us).  Most of this was negotiated and effectuated in complete secrecy, in the sleazy sewers populated by lobbyists, industry insiders, and their wholly-owned pawns in the Congress.  And highly unpopular, industry-serving legislation is passed off as “centrist,” the noblest Beltway value. 

Looked at from the narrow lens of health care policy, there is a reasonable debate to be had among reform advocates over whether this bill is a net benefit or a net harm.  But the idea that the White House did what it could to ensure the inclusion of progressive provisions — or that they were powerless to do anything about it — is absurd on its face.  Whatever else is true, the overwhelming evidence points to exactly what Sen. Feingold said yesterday:  “This bill appears to be legislation that the president wanted in the first place.”

UPDATE:  It’s also worth noting how completely antithetical claims are advanced to defend and excuse Obama.  We’ve long heard — from the most blindly loyal cheerleaders and from Emanuel himself — that progressives should place their trust in the Obama White House to get this done the right way, that he’s playing 11-dimensional chess when everyone else is playing checkers, that Obama is the Long Game Master who will always win.  Then, when a bad bill is produced, the exact opposite claim is hauled out:  it’s not his fault because he’s totally powerless, has nothing to do with this, and couldn’t possibly have altered the outcome.  From his defenders, he’s instantaneously transformed from 11-dimensional chess Master to impotent, victimized bystander.

The supreme goal is to shield him from all blame.  What gets said to accomplish that goal can — and does — radically change from day to day.
UPDATE II:  I’ll be on MSNBC this afternoon at 3:00 p.m. EST with David Shuster/Tamron Hall discussing this post.

UPDATE III:  Over at Politico, Jane Hamsher documents how Joe Lieberman’s conduct on the health care bill provides the perfect vehicle to advance the agenda of the White House and Harry Reid.  Consistent with that, she independently notes media reports that White House officials are privately expressing extreme irritation with Howard Dean for opposing the Senate bill as insufficient, but have nothing bad to say about Lieberman, who supposedly single-handedly sabotaged what the White House was hoping for in this bill.

UPDATE IV:  Immediately prior to the MSNBC segment I just did — video for which I will post when it’s available — an NBC reporter explained how Robert Gibbs used his Press Briefing today to harshly criticize Howard Dean for opposing the health care bill.  Why did Gibbs never publicly cri
ticize people like Blanche Lincoln, Ben Nelson, Joe Lieberman and the like if they were supposedly obstructing and impeding the White House’s agenda on health care reform (this is a point Yglesias acknowledges as a “fair” one)?  Having a Democratic White House publicly criticize a Democratic Senator can be a much more effective pressure tactic than doing so against a former Governor who no longer holds office.

Meanwhile, as one would expect, health insurance stocks are soaring today in response to the industry-serving “health care reform” bill backed by the Democratic Senate and White House — the same people who began advocating for “health care reform” based on the need to restrain on an out-of-control and profit-inflated health insurance industry (h/t Markos).

UPDATE V:  Here’s the roughly 4-minute segment I did with David Shuster today:

http://www.salon.com/news/opinion/glenn_greenwald/2009/12/16/white_house/index.html

By Emily P. Walker
MedPage Today, December 16, 2009

WASHINGTON — In an earnest but doomed attempt to create a single-payer healthcare system, Sen. Bernie Sanders (I-Vt.) brought up a Medicare-for-all amendment to the healthcare reform bill on Wednesday, but was forced to withdraw it in the face of Republican stalling tactics.

Sanders, the chamber’s only vocal proponent of a national health insurance program, introduced an amendment to create just that — and expand coverage to every U.S. citizen.

“Every American — 100%, not 94% — would have health insurance,” he said in an impassioned speech on the Senate floor.

He referred to the current Senate bill, which would expand coverage to 94% of legal U.S. citizens, according to the Congressional Budget Office.

Sanders said his amendment would save $350 billion in administrative expenses by eliminating private insurance companies from the picture.

Sen. Tom Coburn (R-Okla.), an ob/gyn, demanded that the 776-page amendment be read by Senate clerks — a move that is always an option, but very rarely invoked. Coburn complained that he hadn’t seen Sanders’ amendment before it was brought to the floor.

The reading began at noon and continued on for several hours until Sanders withdrew the measure, ending a monotone afternoon read-a-thon that further delayed work on the healthcare measure. Sen. Dick Durbin (D-Ill.) estimated that reading the whole amendment would have taken 10 hours.

After withdrawing the amendment, Sanders delivered a few more pointed words in favor of loosening the insurance industry’s grasp on medical care and the need for universal coverage.

“A Medicare-for-all program is the way to go,” he said. “And I know it’s not going to pass today. I know we don’t have the votes. I know the insurance company and the drug lobbyists will fight us.

“But mark my words . . . the day will come when this country will do the right thing. And on that day, we will pass a Medicare-for-all single-payer system.”

David Himmelstein, MD, the national spokesperson for Physicians for a National Heath Program, told MedPage Today he wasn’t surprised by the maneuvering that blocked the amendment from coming up for a vote.

“It’s another in a long line of bizarre dancing that Congress has been engaged in that distract from debating the issues,” said Himmelstein, an associate professor of medicine at Harvard. “The whole debate has been a circus and sounds like another side show in the circus.”

Himmelstein said he agrees with Sanders that meaningful reform can only be achieved with a single-payer system because there is too much waste in the private insurance industry.

He criticized the current reform effort for “dumping hundreds of billions of dollars into the private insurance industry for a short term gain.”

He said the current debate “is akin to debating whether you ought to use aspirin or Tylenol for someone with cancer.”

After Sanders’ amendment, the Senate took up a defense spending measure.

It is appearing less and less likely that the Senate will vote on healthcare reform before Christmas, which Senate Majority Leader Harry Reid (D-Nev.) has said is his goal.

Reid has yet to introduce his manager’s amendment, which will include a series of changes to the older version of the healthcare bill.

Republicans can again request that the amendment be read aloud. Hoping to avoid that, Democrat leaders have told the GOP that the amendment will be available publicly for at least 72 hours before it’s brought up on the floor.

http://www.medpagetoday.com/PublicHealthPolicy/Washington-Watch/17585